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General NPI Number Information
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NPI Number | 1124784087
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Entity Type | Individual
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Provider Name | REBECCA E BIRNBAUM FNP
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Gender | Female
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Dates
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Enumeration Date | 11/15/2021
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 712 N DEARBORN ST
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City | CHICAGO
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State | IL
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Zip | 60654-3846
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Country | US
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Telephone | 312-951-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 331 NEWMAN SPRINGS ROAD BLDG. 2, SUITE 220
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City | RED BANK
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State | NJ
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Zip | 07701
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Country | US
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Telephone | 732-807-0877
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.023955
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NR25717100
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F349194-01
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License Number State | NY
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