MEDICARE: DR. DAVID ANTHONY BARTHWELL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	36-059077	IL

General Provider Information

NPI Number	:	1043276785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ANTHONY BARTHWELL M.D.

Provider Business Mailing Address
First Line	:	1010 LAKE ST
Second Line	:	SUITE 422
City	:	OAK PARK
State	:	IL
Zip	:	60301-1147
Country	:	US
Telephone Number	:	708-383-2700
Fax Number	:	708-383-2959

Provider Business Practice Location Address
First Line	:	1010 LAKE ST
Second Line	:	SUITE 422
City	:	OAK PARK
State	:	IL
Zip	:	60301-1147
Country	:	US
Telephone Number	:	708-383-2700
Fax Number	:	708-383-2959

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	07/08/2007

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