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General NPI Number Information
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NPI Number | 1710425129
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Entity Type | Organization
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Legal Business Name | RTB SC
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 01/23/2018
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Provider Practice Location Address
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Address Line | 5015 N. PAULINA #225
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City | CHICAGO
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State | IL
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Zip | 60640
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Country | US
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Telephone | 773-561-4440
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Fax | 773-989-1409
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Provider Business Mailing Address
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Address Line | 7011 N. KARLOV
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City | LINCOLNWOOD
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State | IL
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Zip | 60712
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Country | US
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Telephone | 773-366-9813
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Fax | 773-989-1409
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAVI T BARNABAS
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Credential | MD
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Telephone | 773-366-9813
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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 |
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License Number State |
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