Healthcare Provider Details

I. General information

NPI: 1598902272
Provider Name (Legal Business Name): DENISE MARIE BARNES RN,APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2009
Last Update Date: 01/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 N CHILDRENS PLZ
CHICAGO IL
60614-3363
US

IV. Provider business mailing address

3672 BUCKTHORN LN
DOWNERS GROVE IL
60515-1356
US

V. Phone/Fax

Practice location:
  • Phone: 773-880-3842
  • Fax:
Mailing address:
  • Phone: 630-632-9079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number209005042
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: