Provider Demographics
NPI:1790104834
Name:SUMMIT TOTAL HEALTH SC
Entity Type:Organization
Organization Name:SUMMIT TOTAL HEALTH SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-771-1212
Mailing Address - Street 1:339 N SCHMIDT RD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1702
Mailing Address - Country:US
Mailing Address - Phone:630-771-1212
Mailing Address - Fax:
Practice Address - Street 1:339 N SCHMIDT RD
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1702
Practice Address - Country:US
Practice Address - Phone:630-771-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain