Provider Demographics
NPI:1760932628
Name:BARO, ALEX JAMES (ATC, COF)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:JAMES
Last Name:BARO
Suffix:
Gender:M
Credentials:ATC, COF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 WOLF RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5643
Mailing Address - Country:US
Mailing Address - Phone:708-273-8430
Mailing Address - Fax:
Practice Address - Street 1:2450 WOLF RD
Practice Address - Street 2:SUITE G
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5643
Practice Address - Country:US
Practice Address - Phone:708-273-8430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL096.0027962255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer