Provider Demographics
NPI:1275526741
Name:BARNES, DAVID JEFFREY (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JEFFREY
Last Name:BARNES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 W HIGGINS RD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-4926
Mailing Address - Country:US
Mailing Address - Phone:847-885-8820
Mailing Address - Fax:847-885-9578
Practice Address - Street 1:275 W HIGGINS RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-4926
Practice Address - Country:US
Practice Address - Phone:847-885-8820
Practice Address - Fax:847-885-9578
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036103275207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
K08621Medicare ID - Type Unspecified
H40603Medicare UPIN