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NPI Code Detail

MEDICARE: JONATHAN BIRNBERG MD

MEDICARE:   JONATHAN  BIRNBERG  MD
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
1207R00000XInternal Medicine Physician036-122204IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477731396
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN BIRNBERG MD
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-6966
Country : US
Telephone Number : 847-390-5900
Fax Number : 847-390-4757
Provider Business Practice Location Address
First Line : 825 S MILWAUKEE AVE
Second Line :
City : LIBERTYVILLE
State : IL
Zip : 60048-3218
Country : US
Telephone Number : 847-566-5200
Fax Number : 847-556-5522
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2008
Last Update Date : 03/10/2026

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