Provider Demographics
NPI:1376549394
Name:BACALAR, CAREY M (MD)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:M
Last Name:BACALAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 N. BARRINGTON ROAD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169
Mailing Address - Country:US
Mailing Address - Phone:847-882-1121
Mailing Address - Fax:847-882-0041
Practice Address - Street 1:1555 N. BARRINGTON ROAD
Practice Address - Street 2:SUITE 225
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169
Practice Address - Country:US
Practice Address - Phone:847-882-1121
Practice Address - Fax:847-882-0041
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036072156207V00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036072156Medicaid
ILC43960Medicare UPIN