Provider Demographics
NPI:1275000556
Name:BARAD, ADI
Entity Type:Individual
Prefix:
First Name:ADI
Middle Name:
Last Name:BARAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 GREEN BAY RD STE 208
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2241
Mailing Address - Country:US
Mailing Address - Phone:847-446-8911
Mailing Address - Fax:
Practice Address - Street 1:560 GREEN BAY RD STE 208
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-2241
Practice Address - Country:US
Practice Address - Phone:847-446-8911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198000847171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist