Healthcare Provider Details
I. General information
NPI: 1225122344
Provider Name (Legal Business Name): MEDCOR OF BARRINGTON, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4805 PRIME PKWY
MCHENRY IL
60050-7002
US
IV. Provider business mailing address
4805 PRIME PKWY
MCHENRY IL
60050-7002
US
V. Phone/Fax
- Phone: 815-363-9500
- Fax: 815-363-3357
- Phone: 815-363-9500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 060-007663 |
| License Number State | IL |
VIII. Authorized Official
Name:
ALAN
GEGENHEIMER
Title or Position: MEDICAL DIRECTOR
Credential: DO
Phone: 815-363-9500