Provider Demographics
NPI:1295297521
Name:NEWBORN, ADAM JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JOSEPH
Last Name:NEWBORN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9555 SOUTH 52ND AVENUE
Mailing Address - Street 2:SUITE F
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453
Mailing Address - Country:US
Mailing Address - Phone:087-422-5700
Mailing Address - Fax:708-634-0927
Practice Address - Street 1:7501 RIVERSIDE PKWY
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5056
Practice Address - Country:US
Practice Address - Phone:918-710-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL390200000X
IL1295297521207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program