MEDICARE: BARRIE ISAAC LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	150.105358	IL

General Provider Information

NPI Number	:	1134829427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRIE ISAAC LSW

Provider Business Mailing Address
First Line	:	2715 CRABTREE LN
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-3412
Country	:	US
Telephone Number	:	847-513-2658
Fax Number	:

Provider Business Practice Location Address
First Line	:	180 N MICHIGAN AVE STE 1025C
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60601-7999
Country	:	US
Telephone Number	:	773-417-9349
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2023
Last Update Date	:	03/06/2023

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Directions to “ BARRIE ISAAC LSW” Practice Location

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