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General NPI Number Information
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NPI Number | 1588852818
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Entity Type | Organization
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Legal Business Name | BARRINGTON SPECIALISTS IN ADULT MEDICINE
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 22N285 PEPPER RD SUITE 407
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City | LAKE BARRINGTON
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State | IL
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Zip | 60010-5982
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Country | US
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Telephone | 847-382-6633
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Fax | 847-382-6942
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Provider Business Mailing Address
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Address Line | 22N285 PEPPER RD SUITE 407
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City | LK BARRINGTON
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State | IL
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Zip | 60010-5982
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Country | US
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Telephone | 847-382-6633
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Fax | 847-382-6942
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Authorized Official
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Title or Position | PARTNER
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Name | DR. BRUCE E CARLSON
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Credential | M.D.
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Telephone | 847-382-6633
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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 | 336029200
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036060898
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License Number State | IL
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