Provider Demographics
NPI:1811919681
Name:DEAL, BARBARA JANE (MD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JANE
Last Name:DEAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 CHILDRENS PLAZA
Mailing Address - Street 2:BOX 21
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614
Mailing Address - Country:US
Mailing Address - Phone:773-880-4553
Mailing Address - Fax:773-880-8111
Practice Address - Street 1:2300 CHILDRENS PLAZA
Practice Address - Street 2:BOX 21
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614
Practice Address - Country:US
Practice Address - Phone:773-880-4553
Practice Address - Fax:773-880-8111
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360614022080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036061402Medicaid
IL036061402Medicaid
C42998Medicare UPIN