Provider Demographics
NPI:1548384639
Name:FELDMAN, BARRY ROBERT (LCSW)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:ROBERT
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 E GOLF RD
Mailing Address - Street 2:STE 312
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-4071
Mailing Address - Country:US
Mailing Address - Phone:847-593-3333
Mailing Address - Fax:847-952-1374
Practice Address - Street 1:657 E GOLF RD
Practice Address - Street 2:STE 312
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4071
Practice Address - Country:US
Practice Address - Phone:847-593-3333
Practice Address - Fax:847-952-1374
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490005551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210518Medicare ID - Type UnspecifiedPROVIDER NUMBER