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General NPI Number Information
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NPI Number | 1518068725
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Entity Type | Individual
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Provider Name | BARRY COHN MARKELL PSYD
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1420 RENAISSANCE DRIVE SUITE 301-H
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City | PARK RIDGEE
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State | IL
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Zip | 60068
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Country | US
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Telephone | 847-710-0404
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Fax | 801-383-9813
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Provider Business Mailing Address
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Address Line | PO BOX 397
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City | HIGHLAND PARK
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State | IL
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Zip | 60035
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Country | US
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Telephone | 847-710-0404
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Fax | 801-383-9813
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State | IL
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