Provider Demographics
NPI:1134829427
Name:ISAAC, BARRIE (LSW)
Entity type:Individual
Prefix:
First Name:BARRIE
Middle Name:
Last Name:ISAAC
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 CRABTREE LN
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-3412
Mailing Address - Country:US
Mailing Address - Phone:847-513-2658
Mailing Address - Fax:
Practice Address - Street 1:180 N MICHIGAN AVE STE 1025C
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7999
Practice Address - Country:US
Practice Address - Phone:773-417-9349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.105358104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker