Individual
MARK L. BARBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5875 E RIVERSIDE BLVD, ROCKFORD, IL 61114-4937
(815) 398-9491
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036-093362
IL
207X00000X
Orthopaedic Surgery Physician
57247-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093362
—
IL
Enumeration date
08/16/2006
Last updated
11/13/2023
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