Provider Demographics
NPI:1821278219
Name:LYNN BARNETT, M.D., S.C.
Entity Type:Organization
Organization Name:LYNN BARNETT, M.D., S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-480-1346
Mailing Address - Street 1:250 PARKWAY DRIVE
Mailing Address - Street 2:STE 150 #AT107
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069
Mailing Address - Country:US
Mailing Address - Phone:847-480-1346
Mailing Address - Fax:224-545-5075
Practice Address - Street 1:250 PARKWAY DRIVE
Practice Address - Street 2:STE 150 #AT107
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069
Practice Address - Country:US
Practice Address - Phone:847-480-1346
Practice Address - Fax:224-545-5075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360621872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209243OtherMEDICARE ID-TYPE UNSPEC
ILE34311Medicare UPIN