Provider Demographics
NPI:1679765499
Name:BARNABAS, RAVI THOMAS (MD)
Entity type:Individual
Prefix:
First Name:RAVI
Middle Name:THOMAS
Last Name:BARNABAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5015 N PAULINA ST # 225
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2756
Mailing Address - Country:US
Mailing Address - Phone:773-561-4440
Mailing Address - Fax:773-989-1409
Practice Address - Street 1:5015 N PAULINA ST # 225
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2756
Practice Address - Country:US
Practice Address - Phone:773-561-4440
Practice Address - Fax:773-989-1409
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036068798207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine