Provider Demographics
NPI:1114996691
Name:BARTHLAMA, SCOTT JAMES (MS ATC LAT CSCS)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:JAMES
Last Name:BARTHLAMA
Suffix:
Gender:M
Credentials:MS ATC LAT CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 W IRVING PARK RD
Mailing Address - Street 2:#414
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-3123
Mailing Address - Country:US
Mailing Address - Phone:773-450-9296
Mailing Address - Fax:847-491-8865
Practice Address - Street 1:1501 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60208-0840
Practice Address - Country:US
Practice Address - Phone:847-491-5421
Practice Address - Fax:847-491-8865
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer