Healthcare Provider Details
I. General information
NPI: 1326141235
Provider Name (Legal Business Name): CHRISTOPHER ALEXANDER BARBOUR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/06/2006
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
454 E ROOSEVELT RD
LOMBARD IL
60148-4630
US
IV. Provider business mailing address
29373 NETWORK PL
CHICAGO IL
60673-6110
US
V. Phone/Fax
- Phone: 630-620-8061
- Fax: 630-916-7525
- Phone: 847-390-5900
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 173000000X |
| Taxonomy | Legal Medicine |
| License Number | 36-054670 |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 036-054670 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: