Individual
DR. TERRY R LABARRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
351 DELNOR DR, SUITE 100, GENEVA, IL 60134-4220
(630) 232-0280
(630) 232-3895
Mailing address
351 DELNOR DR, SUITE 100, GENEVA, IL 60134-4220
(630) 232-0280
(630) 232-3895
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036063109
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036063109
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
01
—
206147060
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
P00944597
RR MEDICARE PTAN (INDIVIDUAL)
IL
Enumeration date
09/27/2005
Last updated
05/14/2012
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