Agoritsa Renee Barczak, PSY.D.

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

071.008462 Issued in IL

Practice address

757 E Fabyan Pkwy
Batavia, IL 60510-1403

Phone

(630) 444-1085

Fax

(630) 262-4484

NPI assigned

Oct 2, 2009

Last updated

Feb 13, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1306171772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 E FABYAN PKWY",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101403",
            "telephone_number": "630-444-1085",
            "fax_number": "630-262-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 E FABYAN PKWY",
            "city": "BATAVIA",
            "state": "IL",
            "postal_code": "605101403",
            "telephone_number": "630-444-1085",
            "fax_number": "630-262-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARCZAK",
        "first_name": "AGORITSA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-02",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008462",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "IL",
            "license": "071.008462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "01623882",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber August-Gilio, RN
• Errin Bald
• Charles Edward Balek, D.D.S.
• Keaira Banks
• Joslyn Barajas, MSW
• Jennifer Dawn Baron, MA CCC SLP
• Ellie Jee Min Barth
• Batavia Back & Neck Center SC
• Batavia Back & Neck LTD
• Batavia Dental PC

• Forensic Psychologist in Batavia, IL
• Providers in Batavia, IL by specialty
• Forensic Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.