Provider Demographics
NPI:1417055765
Name:BURRELL, BARBARA FRANCES (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:FRANCES
Last Name:BURRELL
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 1:650 DAKOTA ST STE A
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60012-3744
Mailing Address - Country:US
Mailing Address - Phone:815-455-6000
Mailing Address - Fax:815-356-3914
Practice Address - Street 1:650 DAKOTA ST STE A
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60012
Practice Address - Country:US
Practice Address - Phone:815-455-6000
Practice Address - Fax:815-356-3914
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036103946207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036103946OtherSTATE LICENSE