Provider Demographics
NPI:1790156354
Name:BURKE, M. BARBARA (MD)
Entity Type:Individual
Prefix:DR
First Name:M. BARBARA
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10028 S ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-1537
Mailing Address - Country:US
Mailing Address - Phone:509-860-4064
Mailing Address - Fax:
Practice Address - Street 1:4700 E GALBRAITH RD STE 102
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2754
Practice Address - Country:US
Practice Address - Phone:513-924-8535
Practice Address - Fax:513-924-8559
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.0679102086X0206X
OH35133138208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology