Provider Demographics
NPI:1083733802
Name:BARENBERG, CAROLYN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:
Last Name:BARENBERG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 S COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-4764
Mailing Address - Country:US
Mailing Address - Phone:630-986-5974
Mailing Address - Fax:630-986-0100
Practice Address - Street 1:3025 E NEW YORK ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-5160
Practice Address - Country:US
Practice Address - Phone:630-236-0847
Practice Address - Fax:630-236-0850
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist