Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | D0064804 | MD |
Y | 208200000X | Surgeon | 036.153500 | IL |
Y | 208600000X | Surgeon | 036.153500 | IL |
NPI | 1861435182 |
---|---|
Provider Name | Rolf N. Barth |
First Address | Chicago, IL 60615-2806 |
Second Address | Chicago, IL 60637-1443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 03/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I17639 | (02) | WI |