Provider Demographics
NPI:1508984907
Name:BERRIER, DAVID WAYNE (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WAYNE
Last Name:BERRIER
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 1:5737 S UNIVERSITY AVE
Mailing Address - Street 2:STUDENT COUNSELING AND RESOURCE CENTER
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1507
Mailing Address - Country:US
Mailing Address - Phone:773-702-9800
Mailing Address - Fax:773-702-2011
Practice Address - Street 1:5737 S UNIVERSITY AVE
Practice Address - Street 2:STUDENT COUNSELING AND RESOURCE CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1507
Practice Address - Country:US
Practice Address - Phone:773-702-9800
Practice Address - Fax:773-702-2011
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360870032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036087003Medicaid
IL036087003Medicaid