Healthcare Provider Details

I. General information

NPI: 1952599706
Provider Name (Legal Business Name): BARRY M GERSHUNY MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2007
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 SHERMER RD SUITE 208
NORTHBROOK IL
60062-4500
US

IV. Provider business mailing address

1200 SHERMER RD SUITE 208
NORTHBROOK IL
60062-4500
US

V. Phone/Fax

Practice location:
  • Phone: 847-480-0132
  • Fax: 847-480-1348
Mailing address:
  • Phone: 847-480-0132
  • Fax: 847-480-1348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. BARRY M GERSHUNY
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 847-480-0132