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General NPI Number Information
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NPI Number | 1598780942
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Entity Type | Individual
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Provider Name | MICHELLE B BURNS D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 20180 S LAGRANGE RD
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City | FRANKFORT
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State | IL
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Zip | 60423
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Country | US
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Telephone | 815-464-2010
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Fax | 815-464-2181
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Provider Business Mailing Address
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Address Line | 35318 EAGLE WAY
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City | CHICAGO
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State | IL
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Zip | 60678-1353
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Country | US
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Telephone | 317-528-4800
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Fax | 317-865-1479
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 36-093722
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License Number State | IL
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