Provider Demographics
NPI:1851661771
Name:FORBES, SHIRLEY J (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:J
Last Name:FORBES
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 1:351 SHARON DR
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3412
Mailing Address - Country:US
Mailing Address - Phone:847-381-8493
Mailing Address - Fax:
Practice Address - Street 1:351 SHARON DR
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-3412
Practice Address - Country:US
Practice Address - Phone:847-381-8493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360551142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036055114Medicaid
ILD14322Medicare UPIN