Provider Demographics
NPI:1982758793
Name:BARNES, ANN T (PSYD RD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:T
Last Name:BARNES
Suffix:
Gender:F
Credentials:PSYD RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 FEEHANVILLE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-6036
Mailing Address - Country:US
Mailing Address - Phone:847-981-9200
Mailing Address - Fax:847-981-9322
Practice Address - Street 1:1660 FEEHANVILLE DR STE 400
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-6036
Practice Address - Country:US
Practice Address - Phone:847-981-9200
Practice Address - Fax:847-981-9322
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071005380103TC0700X
IL133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILL79562Medicare ID - Type Unspecified