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General NPI Number Information
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NPI Number | 1336907021
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Entity Type | Organization
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Legal Business Name | AMBER BARD MD LLC
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Dates
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Enumeration Date | 03/08/2024
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 11 DOUGLAS AVE STE 251 #202
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City | ELGIN
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State | IL
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Zip | 60120
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Country | US
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Telephone | 269-339-8831
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Fax |
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Provider Business Mailing Address
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Address Line | 11 DOUGLAS AVE STE 251 #202
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City | ELGIN
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State | IL
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Zip | 60120
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | AMBER BARD
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Credential | MD
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Telephone | 847-994-4488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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