Robert Cipolla

Individual provider Active NPI Family Medicine Physician · Clinton, IL

NPI 1649370271 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1649370271
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
Practice address
1231 Kleemann Dr
Clinton, IL 61727-2633
Phone
(217) 935-5022
Fax
(217) 935-9592
NPI assigned
Sep 24, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-068758ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charles Cole Memorial Hospital D/B/a Upmc Cole Past Accepting new patients
Charles Cole Memorial D/B/a Upmc Cole Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Yes

Addresses

Primary practice location

1231 Kleemann Dr
Clinton, IL 61727-2633

Mailing address

1231 Kleemann Dr
Clinton, IL 61727-2633
Phone (217) 935-5022

Other providers in Clinton, IL

All providers in Clinton, IL · Family Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.