Provider Demographics
NPI:1720422611
Name:RENEE BURKE MD PC
Entity Type:Organization
Organization Name:RENEE BURKE MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-382-4400
Mailing Address - Street 1:18 E. DUNDEE ROAD
Mailing Address - Street 2:BLDG. 3, SUITE 200
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5273
Mailing Address - Country:US
Mailing Address - Phone:847-382-4400
Mailing Address - Fax:847-382-4403
Practice Address - Street 1:18 E. DUNDEE ROAD
Practice Address - Street 2:BLDG. 3, SUITE 200
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5273
Practice Address - Country:US
Practice Address - Phone:847-382-4400
Practice Address - Fax:847-382-4403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036127968174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty