Healthcare Provider Details

I. General information

NPI: 1992776322
Provider Name (Legal Business Name): ROBERT J BARNES MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 09/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N HIGHLAND AVE STE 1
AURORA IL
60506
US

IV. Provider business mailing address

1300 N HIGHLAND AVE STE 1
AURORA IL
60506
US

V. Phone/Fax

Practice location:
  • Phone: 630-897-5104
  • Fax: 630-897-5089
Mailing address:
  • Phone: 630-897-5104
  • Fax: 630-897-5089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number042006224
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT J BARNES
Title or Position: PRESIDENT
Credential: MD
Phone: 630-897-5104