Individual
MICHELLE A PIPITONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
885 ROOSEVELT RD, GLEN ELLYN, IL 60137-6141
(630) 315-6500
(630) 315-6519
Mailing address
885 ROOSEVELT RD, GLEN ELLYN, IL 60137-6141
(630) 315-6500
(630) 315-6519
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
036115984
IL
207N00000X
Dermatology Physician
35085157
OH
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
036115984
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009900257
BCBS PROVIDER NUMBER
IL
01
—
036115984
MEDICAID
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
F400254126
MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
05/17/2006
Last updated
04/29/2026
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