Healthcare Provider Details

I. General information

NPI: 1235342429
Provider Name (Legal Business Name): ROBERT J BARABAS OD, FAAO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 N. LA SALLE STREET SUITE 155
CHICAGO IL
60602
US

IV. Provider business mailing address

2 N. LA SALLE STREET SUITE 155
CHICAGO IL
60602
US

V. Phone/Fax

Practice location:
  • Phone: 312-236-7538
  • Fax: 312-236-1205
Mailing address:
  • Phone: 312-236-7538
  • Fax: 312-236-1205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: