Provider Demographics
NPI:1558368803
Name:BARTOLOMEO, ORAZIO (MD)
Entity Type:Individual
Prefix:
First Name:ORAZIO
Middle Name:
Last Name:BARTOLOMEO
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 1:120 N NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3347
Mailing Address - Country:US
Mailing Address - Phone:847-382-6579
Mailing Address - Fax:847-382-7194
Practice Address - Street 1:120 N NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-3347
Practice Address - Country:US
Practice Address - Phone:847-382-6579
Practice Address - Fax:847-382-7194
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036094823207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036094823Medicaid
IL080195296OtherPALMETO RAILROAD MEDICARE
IL4923117OtherBCBS OF IL
IL080195296OtherPALMETO RAILROAD MEDICARE
ILG55048Medicare UPIN