MEDICARE: DR. HOWARD MARK BARTMAN 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	207R00000X	Internal Medicine Physician	036-055478	IL

General Provider Information

NPI Number	:	1871528653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HOWARD MARK BARTMAN M.D.

Provider Business Mailing Address
First Line	:	6374 N LINCOLN AVE
Second Line	:	201
City	:	CHICAGO
State	:	IL
Zip	:	60659-1275
Country	:	US
Telephone Number	:	312-738-6170
Fax Number	:	312-942-1554

Provider Business Practice Location Address
First Line	:	6374 N LINCOLN AVE
Second Line	:	201
City	:	CHICAGO
State	:	IL
Zip	:	60659-1275
Country	:	US
Telephone Number	:	312-738-6170
Fax Number	:	312-942-1554

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	06/07/2008

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