Provider Demographics
NPI:1043238306
Name:BURKE, JOHN H (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:BURKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3545 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2135
Mailing Address - Country:US
Mailing Address - Phone:708-346-5562
Mailing Address - Fax:708-346-2059
Practice Address - Street 1:3545 W 95TH ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2135
Practice Address - Country:US
Practice Address - Phone:708-346-5562
Practice Address - Fax:708-346-2059
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-075929207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1619991361OtherGROUP NPI#
IL1477731685OtherGROUP NPI#
ILIL4014002OtherMEDICARE PTAN#
ILP00713299/CK6882OtherMEDICARE RAILROAD
IL036075929Medicaid
ILIL4013002OtherMEDICARE PTAN#
0001619074OtherGROUP BC/BS
685583OtherGROUP MEDICARE#
IL1619991361OtherGROUP NPI#
IL036075929Medicaid
IL1477731685OtherGROUP NPI#
ILIL4013002OtherMEDICARE PTAN#
IL1619991361OtherGROUP NPI#
IN256640BMedicare UPIN
060031015Medicare ID - Type UnspecifiedRAILROAD
IL216251Medicare PIN