Provider Demographics
NPI:1871528653
Name:BARTMAN, HOWARD MARK (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:MARK
Last Name:BARTMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6374 N LINCOLN AVE
Mailing Address - Street 2:201
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-1275
Mailing Address - Country:US
Mailing Address - Phone:312-738-6170
Mailing Address - Fax:312-942-1554
Practice Address - Street 1:6374 N LINCOLN AVE
Practice Address - Street 2:201
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-1275
Practice Address - Country:US
Practice Address - Phone:312-738-6170
Practice Address - Fax:312-942-1554
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2008-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-055478207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL614250Medicare PIN
ILD13911Medicare UPIN