Provider Demographics
NPI:1821174491
Name:BARKER, DEBORAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:BARKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 ELLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-5918
Mailing Address - Country:US
Mailing Address - Phone:847-498-0543
Mailing Address - Fax:
Practice Address - Street 1:4833 CHURCH ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1357
Practice Address - Country:US
Practice Address - Phone:847-673-7118
Practice Address - Fax:847-673-4709
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice