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NPI Code Detail

MEDICARE: BARBARA HERMAN BAYNE LCSW

MEDICARE: BARBARA HERMAN BAYNE LCSW
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
11041C0700XClinical Social Worker149015422IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1996340012OTHERILPTAN
21477816247OTHERILNPI

General Provider Information

NPI Number : 1528317443
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA HERMAN BAYNE LCSW
Provider Business Mailing Address
First Line : 1770 W BERTEAU AVE STE 302A
Second Line :
City : CHICAGO
State : IL
Zip : 60613-1750
Country : US
Telephone Number : 773-850-0526
Fax Number : 888-965-1182
Provider Business Practice Location Address
First Line : 1770 W BERTEAU AVE STE 302A
Second Line :
City : CHICAGO
State : IL
Zip : 60613-1750
Country : US
Telephone Number : 773-850-0526
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2012
Last Update Date : 10/30/2019

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