Provider Demographics
NPI:1518068725
Name:MARKELL, BARRY COHN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:COHN
Last Name:MARKELL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 397
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035
Mailing Address - Country:US
Mailing Address - Phone:847-710-0404
Mailing Address - Fax:801-383-9813
Practice Address - Street 1:1420 RENAISSANCE DRIVE
Practice Address - Street 2:SUITE 301-H
Practice Address - City:PARK RIDGEE
Practice Address - State:IL
Practice Address - Zip Code:60068
Practice Address - Country:US
Practice Address - Phone:847-710-0404
Practice Address - Fax:801-383-9813
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL975031Medicare ID - Type Unspecified