Provider Demographics
NPI:1922035195
Name:SASIK, BARBARA IRENA (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:IRENA
Last Name:SASIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:IRENA
Other - Last Name:SASIK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:400 E IRVING PARK
Mailing Address - Street 2:
Mailing Address - City:WOOD DALE
Mailing Address - State:IL
Mailing Address - Zip Code:60191
Mailing Address - Country:US
Mailing Address - Phone:630-616-9461
Mailing Address - Fax:630-616-9467
Practice Address - Street 1:400 E IRVING PARK
Practice Address - Street 2:
Practice Address - City:WOOD DALE
Practice Address - State:IL
Practice Address - Zip Code:60191
Practice Address - Country:US
Practice Address - Phone:630-616-9461
Practice Address - Fax:630-616-9467
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-085700207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036085700Medicaid
IL036085700Medicaid
ILF73186Medicare UPIN