Provider Demographics
NPI:1891765095
Name:BARNETT, ARDEN DAVIS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ARDEN
Middle Name:DAVIS
Last Name:BARNETT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8927
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-8927
Mailing Address - Country:US
Mailing Address - Phone:847-599-1141
Mailing Address - Fax:847-599-1187
Practice Address - Street 1:200 S GREENLEAF ST
Practice Address - Street 2:STE. A
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3398
Practice Address - Country:US
Practice Address - Phone:847-244-5660
Practice Address - Fax:847-244-5669
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01060002A2084P0800X
IL0360721142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200520270Medicaid
IN200520270Medicaid
E30994Medicare UPIN