Provider Demographics
NPI:1639285224
Name:SHARYL E BALKIN MD PC
Entity Type:Organization
Organization Name:SHARYL E BALKIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARYL
Authorized Official - Middle Name:E
Authorized Official - Last Name:BALKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-304-0781
Mailing Address - Street 1:100 FOX GLENN RD
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1805
Mailing Address - Country:US
Mailing Address - Phone:847-304-0781
Mailing Address - Fax:847-304-2650
Practice Address - Street 1:100 FOX GLEN ROAD
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1805
Practice Address - Country:US
Practice Address - Phone:847-304-0781
Practice Address - Fax:847-304-2650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL360752242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210765Medicare PIN