Healthcare Provider Details

I. General information

NPI: 1164591301
Provider Name (Legal Business Name): BARBARA A SOLTES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 03/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W. HARRISON STREET SUITE 739
CHICAGO IL
60612
US

IV. Provider business mailing address

1653 W CONGRESS PKWY
CHICAGO IL
60612-3833
US

V. Phone/Fax

Practice location:
  • Phone: 312-563-9389
  • Fax: 312-563-9349
Mailing address:
  • Phone: 312-563-9389
  • Fax: 312-563-9349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number036080083
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: