Basic Information
| Provider Information | |||||||||
| NPI: | 1871860940 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BARRINGTON FAMILY INSTITUTE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 LIONS DR | ||||||||
| Address2: | SUITE 119 | ||||||||
| City: | BARRINGTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600103181 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8478420771 | ||||||||
| FaxNumber: | 7737512250 | ||||||||
| Practice Location | |||||||||
| Address1: | 101 LIONS DR | ||||||||
| Address2: | SUITE 119 | ||||||||
| City: | BARRINGTON | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600103181 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8478420771 | ||||||||
| FaxNumber: | 7737512250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2011 | ||||||||
| LastUpdateDate: | 11/17/2011 | ||||||||
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| AuthorizedOfficialLastName: | WAGNER | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 8478420771 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 036085205 | IL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.