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NPI Code Detail

MEDICARE: CHERISE BARRON PA

MEDICARE:   CHERISE  BARRON  PA
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
1363A00000XPhysician Assistant085-002491IL

General Provider Information

NPI Number : 1952356701
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERISE BARRON PA
Provider Business Mailing Address
First Line : 1500 S FAIRFIELD AVE # C1500
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1782
Country : US
Telephone Number : 773-257-6663
Fax Number :
Provider Business Practice Location Address
First Line : 1500 S FAIRFIELD AVE # C1500
Second Line :
City : CHICAGO
State : IL
Zip : 60608-1782
Country : US
Telephone Number : 773-257-6663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 03/17/2021

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Directions to “ CHERISE BARRON PA” Practice Location

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