=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437488483
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARY BARRY AND ASSOCIATES, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/21/2009
-----------------------------------------------------
Last Update Date | 12/21/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15 SPINNING WHEEL RD SUITE 117
-----------------------------------------------------
City | HINSDALE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60521-2914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-654-8888
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15 SPINNING WHEEL RD SUITE 117
-----------------------------------------------------
City | HINSDALE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60521-2914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-654-8888
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SPEECH-LANGUAGE PATHOLOGIST
-----------------------------------------------------
Name | MARY C. BARRY
-----------------------------------------------------
Credential | M.A., C.C.C./L
-----------------------------------------------------
Telephone | 630-654-8888
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QH0700X
-----------------------------------------------------
Taxonomy Name | Hearing and Speech Clinic/Center
-----------------------------------------------------
License Number | 146-000241
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------