Basic Information
| Provider Information | |||||||||
| NPI: | 1649300385 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KIRSCHNER | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | S. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNIVERSITY OF CHICAGO, PEDS GASTRO | ||||||||
| Address2: | 5839 SOUTH MARYLAND AVENUE, MC 4065 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606371470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7737026418 | ||||||||
| FaxNumber: | 7737020666 | ||||||||
| Practice Location | |||||||||
| Address1: | UNIVERSITY OF CHICAGO, PEDS GASTRO | ||||||||
| Address2: | 5839 SOUTH MARYLAND AVENUE, MC 4065 | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606371470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7737026418 | ||||||||
| FaxNumber: | 7737020666 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0206X | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 2000017480 | 05 | IN | MEDICAID |