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NPI Code Detail

MEDICARE: BARBARA C ROY

MEDICARE:   BARBARA C ROY
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
1101YP2500XProfessional CounselorIL

General Provider Information

NPI Number : 1164575494
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA C ROY
Provider Business Mailing Address
First Line : 5443 S CORNELL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60615-5603
Country : US
Telephone Number : 773-288-8022
Fax Number :
Provider Business Practice Location Address
First Line : 5443 S CORNELL AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60615-5603
Country : US
Telephone Number : 773-288-8022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 07/08/2007

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Directions to “ BARBARA C ROY ” Practice Location

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