Healthcare Provider Details

I. General information

NPI: 1376263475
Provider Name (Legal Business Name): JOSHUA CHARLES BARNETT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2022
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3304 N LINCOLN AVE STE G
CHICAGO IL
60657-1108
US

IV. Provider business mailing address

4322 N SHERIDAN RD APT 303
CHICAGO IL
60613-1401
US

V. Phone/Fax

Practice location:
  • Phone: 847-337-9899
  • Fax: 312-277-7194
Mailing address:
  • Phone: 773-354-6436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150.109915
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: