Provider Demographics
NPI:1942854211
Name:BARNUM, TREVOR JAMES (DNP, APRN , FNP-BC)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:JAMES
Last Name:BARNUM
Suffix:
Gender:M
Credentials:DNP, APRN , FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 N SAINT CLAIR ST FL 17
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5975
Mailing Address - Country:US
Mailing Address - Phone:312-695-3800
Mailing Address - Fax:312-695-3644
Practice Address - Street 1:675 N SAINT CLAIR ST FL 17
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5975
Practice Address - Country:US
Practice Address - Phone:312-695-3800
Practice Address - Fax:312-695-3644
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.019645363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily