Provider Demographics
NPI:1437048261
Name:BARR, MARY GRACE
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:GRACE
Last Name:BARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6065 N FOREST GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5013
Mailing Address - Country:US
Mailing Address - Phone:773-319-2206
Mailing Address - Fax:
Practice Address - Street 1:16923 JOANNE DR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136-4146
Practice Address - Country:US
Practice Address - Phone:402-297-3778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant