Provider Demographics
NPI:1609840503
Name:BARNES, ROBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:BARNES
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 1:1300 N HIGHLAND AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-1451
Mailing Address - Country:US
Mailing Address - Phone:630-897-5104
Mailing Address - Fax:630-897-5089
Practice Address - Street 1:1300 N HIGHLAND AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-1451
Practice Address - Country:US
Practice Address - Phone:630-897-5104
Practice Address - Fax:630-897-5089
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36067033207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36067033Medicaid
02201589OtherBC/BS (GEOA)
IL0360670334Medicaid
IL36-3500115OtherFEIN
4099504OtherAETNA (GEOA)
C13182Medicare UPIN
IL0360670334Medicaid
IL0888960001Medicare NSC
IL759400Medicare PIN
IL180007773Medicare Oscar/Certification
759403Medicare PIN