Provider Demographics
NPI:1114957156
Name:BARSKY, BONNIE L (MD)
Entity Type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:L
Last Name:BARSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BONNIE
Other - Middle Name:L
Other - Last Name:VAINDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:400 SKOKIE BLVD
Mailing Address - Street 2:SUITE 475
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2816
Mailing Address - Country:US
Mailing Address - Phone:847-272-4433
Mailing Address - Fax:
Practice Address - Street 1:400 SKOKIE BLVD STE 475
Practice Address - Street 2:
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-7930
Practice Address - Country:US
Practice Address - Phone:847-272-4433
Practice Address - Fax:847-272-4434
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036062019174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL549020OtherMEDICARE GROUP
IL549020OtherMEDICARE GROUP
IL554710Medicare ID - Type Unspecified