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General NPI Number Information
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NPI Number | 1003097619
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Entity Type | Organization
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Legal Business Name | BARRY M SUMMERS,MD,SC
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 05/10/2018
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Provider Practice Location Address
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Address Line | 3000 N HALSTED ST STE 401
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City | CHICAGO
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State | IL
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Zip | 60657-9268
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Country | US
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Telephone | 773-935-5985
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Fax | 773-935-5478
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Provider Business Mailing Address
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Address Line | 3000 N HALSTED ST STE 401
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City | CHICAGO
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State | IL
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Zip | 60657-9268
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Country | US
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Telephone | 773-935-5985
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Fax | 773-935-5478
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MICHELLE L JARKA
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Credential |
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Telephone | 773-935-5985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036083079
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License Number State | IL
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