Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 071-003103 | IL |
Y | 103T00000X | Psychologist | 071-003103 | IL |
NPI | 1013916998 |
---|---|
Provider Name | Barry Alpert |
First Address | Northbrook, IL 60062-2727 |
Second Address | Northbrook, IL 60062-2727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0001673261 | BLUECROSS BLUESHIELD (01) | IL |
0004598959 | AETNA (01) | IL |
026468 | VALUEOPTIONS (01) | IL |