Provider Demographics
NPI:1609232404
Name:HAAS, BARBARA
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:HAAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 S MICHIGAN AVE
Mailing Address - Street 2:UNIT 1810
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2416
Mailing Address - Country:US
Mailing Address - Phone:647-200-8440
Mailing Address - Fax:
Practice Address - Street 1:1212 S MICHIGAN AVE
Practice Address - Street 2:UNIT 1810
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2416
Practice Address - Country:US
Practice Address - Phone:647-200-8440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-139281208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery