Provider Demographics
NPI:1386618775
Name:BARBATO, REBECCA A (MD)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:BARBATO
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2160 S FIRST AVE
Mailing Address - Street 2:(1950 S. HARLEM AVENUE, NO.RIVERSIDE, IL. 60546)
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153
Mailing Address - Country:US
Mailing Address - Phone:708-354-9250
Mailing Address - Fax:708-354-8765
Practice Address - Street 1:2160 S FIRST AVE
Practice Address - Street 2:(1950 S. HARLEM AVENUE, NO.RIVERSIDE, IL. 60546)
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153
Practice Address - Country:US
Practice Address - Phone:708-354-9250
Practice Address - Fax:708-354-8765
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL36104107208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36104107Medicaid
H65035Medicare UPIN
IL36104107Medicaid