Provider Demographics
NPI:1245214386
Name:BARTON, JULIE (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BARTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 NORTH LAKESHORE DRIVE SUITE 824
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-8702
Mailing Address - Country:US
Mailing Address - Phone:312-943-3300
Mailing Address - Fax:312-568-4654
Practice Address - Street 1:680 N LAKE SHORE DR
Practice Address - Street 2:SUITE 824
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4546
Practice Address - Country:US
Practice Address - Phone:312-943-3300
Practice Address - Fax:312-568-4654
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036081087174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
F31758Medicare UPIN