Healthcare Provider Details

I. General information

NPI: 1134361066
Provider Name (Legal Business Name): ENSIGN MEDICAL INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 HIGHLAND AVE SUITE 3E
DOWNERS GROVE IL
60515-1552
US

IV. Provider business mailing address

2200 S MAIN ST STE 301
LOMBARD IL
60148-5366
US

V. Phone/Fax

Practice location:
  • Phone: 630-810-0358
  • Fax: 630-810-5404
Mailing address:
  • Phone: 630-810-0358
  • Fax: 630-810-5404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036068503
License Number StateIL

VIII. Authorized Official

Name: DR. RICHARD KENT BARTON SR.
Title or Position: PRESIDENT
Credential: M.D.
Phone: 630-810-0358