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General NPI Number Information
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NPI Number | 1720422611
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Entity Type | Organization
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Legal Business Name | RENEE BURKE MD PC
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Dates
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Enumeration Date | 04/22/2013
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Last Update Date | 08/21/2013
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Provider Practice Location Address
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Address Line | 18 E. DUNDEE ROAD BLDG. 3, SUITE 200
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City | BARRINGTON
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State | IL
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Zip | 60010-5273
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Country | US
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Telephone | 847-382-4400
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Fax | 847-382-4403
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Provider Business Mailing Address
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Address Line | 18 E. DUNDEE ROAD BLDG. 3, SUITE 200
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City | BARRINGTON
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State | IL
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Zip | 60010-5273
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Country | US
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Telephone | 847-382-4400
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Fax | 847-382-4403
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Authorized Official
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Title or Position | OWNER
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Name | DR. RENEE M BURKE
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Credential | M.D.
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Telephone | 847-382-4400
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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 | 036127968
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License Number State | IL
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