Healthcare Provider Details
I. General information
NPI: 1215224159
Provider Name (Legal Business Name): BARBARA A SOLTES MDSC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2011
Last Update Date: 03/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12400 S HARLEM AVE STE 110
PALOS HEIGHTS IL
60463-1477
US
IV. Provider business mailing address
12400 S HARLEM AVE STE 110
PALOS HEIGHTS IL
60463-1477
US
V. Phone/Fax
- Phone: 708-385-6989
- Fax: 708-385-6949
- Phone: 708-385-6989
- Fax: 708-385-6949
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VE0102X |
| Taxonomy | Reproductive Endocrinology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
BARBARA
A
SOLTES
Title or Position: OWNER / DIRECTOR
Credential: M.D.
Phone: 708-385-6710