MEDICARE: DR. PETER BARATH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	036091171	IL

General Provider Information

NPI Number	:	1639418791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER BARATH M.D.

Provider Business Mailing Address
First Line	:	3 HAMPTON DR
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1713
Country	:	US
Telephone Number	:	630-850-9441
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 HAMPTON DR
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1713
Country	:	US
Telephone Number	:	630-850-9441
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2013
Last Update Date	:	02/10/2013

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