Provider Demographics
NPI:1013916998
Name:ALPERT, BARRY (PHD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:ALPERT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:666 DUNDEE RD
Mailing Address - Street 2:SUITE 1302
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2727
Mailing Address - Country:US
Mailing Address - Phone:847-400-5588
Mailing Address - Fax:847-400-5828
Practice Address - Street 1:666 DUNDEE RD
Practice Address - Street 2:SUITE 1302
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2727
Practice Address - Country:US
Practice Address - Phone:847-400-5588
Practice Address - Fax:847-400-5828
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-003103103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001673261OtherBLUECROSS BLUESHIELD
IL0004598959OtherAETNA
IL026468OtherVALUEOPTIONS
IL951610Medicare ID - Type Unspecified