Provider Demographics
NPI:1316973423
Name:BARRIUSO, EDUARDO VICTOR (MD)
Entity type:Individual
Prefix:DR
First Name:EDUARDO
Middle Name:VICTOR
Last Name:BARRIUSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:910 BURR OAK CT
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1514
Mailing Address - Country:US
Mailing Address - Phone:630-941-8369
Mailing Address - Fax:630-941-8372
Practice Address - Street 1:6035 W. CERMAK ROAD
Practice Address - Street 2:
Practice Address - City:CICERO
Practice Address - State:IL
Practice Address - Zip Code:60804
Practice Address - Country:US
Practice Address - Phone:708-222-6800
Practice Address - Fax:708-222-6862
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36-043695207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2172016OtherCIGNA
IL036043695Medicaid
IL216-20892OtherBLUE CROSS & SHIELD
IL455170Medicare ID - Type Unspecified
ILD12152Medicare UPIN