Provider Demographics
NPI:1811191570
Name:BARTON, DIANE M (DC)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:BARTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18665 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-3728
Mailing Address - Country:US
Mailing Address - Phone:708-922-1400
Mailing Address - Fax:708-922-1451
Practice Address - Street 1:18665 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-3728
Practice Address - Country:US
Practice Address - Phone:708-922-1400
Practice Address - Fax:708-922-1451
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT39011Medicare UPIN
IL212870Medicare ID - Type Unspecified