Organization
CYNTHIA L BARTHOLOW MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA L BARTHOLOW MD (OWNER)
(847) 853-9100
Entity
Organization
Contact information
Practice address
1921 LAKE AVE STE B, WILMETTE, IL 60091-1480
(847) 853-9100
(847) 853-9103
Mailing address
1921 LAKE AVE STE B, WILMETTE, IL 60091-1480
(847) 853-9100
(847) 853-9103
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036 081882
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102355559
MEDICARE RAILROAD PROVIDER PTAN
IL
01
—
IL5671001
MEDICARE PTAN
IL
Enumeration date
02/19/2010
Last updated
03/24/2012
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