Provider Demographics
NPI:1982886214
Name:ROBERT S. KIPFERL, DPM S.C.
Entity type:Organization
Organization Name:ROBERT S. KIPFERL, DPM S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST/FOOT & ANKLE SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:KIPFERL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:847-639-2525
Mailing Address - Street 1:912 NORTHWEST HWY
Mailing Address - Street 2:SUITE G6
Mailing Address - City:FOX RIVER GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60021-1925
Mailing Address - Country:US
Mailing Address - Phone:847-639-2525
Mailing Address - Fax:847-639-2522
Practice Address - Street 1:912 NORTHWEST HWY
Practice Address - Street 2:SUITE G6
Practice Address - City:FOX RIVER GROVE
Practice Address - State:IL
Practice Address - Zip Code:60021-1925
Practice Address - Country:US
Practice Address - Phone:847-639-2525
Practice Address - Fax:847-639-2522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210475Medicare PIN
IL210476Medicare PIN