Provider Demographics
NPI:1871860940
Name:BARRINGTON FAMILY INSTITUTE
Entity type:Organization
Organization Name:BARRINGTON FAMILY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:H
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-842-0771
Mailing Address - Street 1:101 LIONS DR
Mailing Address - Street 2:SUITE 119
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-3181
Mailing Address - Country:US
Mailing Address - Phone:847-842-0771
Mailing Address - Fax:773-751-2250
Practice Address - Street 1:101 LIONS DR
Practice Address - Street 2:SUITE 119
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-3181
Practice Address - Country:US
Practice Address - Phone:847-842-0771
Practice Address - Fax:773-751-2250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360852052084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL5591Medicare Oscar/Certification