Provider Demographics
NPI:1588852818
Name:BARRINGTON SPECIALISTS IN ADULT MEDICINE
Entity type:Organization
Organization Name:BARRINGTON SPECIALISTS IN ADULT MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-382-6633
Mailing Address - Street 1:22N285 PEPPER RD
Mailing Address - Street 2:SUITE 407
Mailing Address - City:LK BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-5982
Mailing Address - Country:US
Mailing Address - Phone:847-382-6633
Mailing Address - Fax:847-382-6942
Practice Address - Street 1:22N285 PEPPER RD
Practice Address - Street 2:SUITE 407
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-5982
Practice Address - Country:US
Practice Address - Phone:847-382-6633
Practice Address - Fax:847-382-6942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL336029200174400000X
IL036060898174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036060898Medicaid
IL036060898Medicaid
ILL19606Medicare PIN
ILD14439Medicare UPIN
ILL19605Medicare PIN