Individual provider Active NPI

Roberta Ann Barker, PH.D.

  • Psychologist
  • Park Ridge, IL
National Provider Identifier
1760514657
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
2604 Dempster St
Suite 308
Park Ridge, IL 60068-8412
Phone
(847) 699-1306
Fax
(847) 299-1521
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X IL Primary

Addresses

Primary practice location

2604 Dempster St
Suite 308
Park Ridge, IL 60068-8412

Mailing address

2604 Dempster St
Suite 308
Park Ridge, IL 60068-8412
Phone (847) 699-1306

Other identifiers 1

IdentifierTypeStateIssuer
01672647OtherILBLUE SHIELD PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060220000362 IL Practitioner - Clinical Psychologist 1254346778 Practice locations: Park Ridge, IL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2604 E Dempster St
Suite 308
Park Ridge, IL 60068-8427
Phone (847) 401-9674

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071.002041ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
West Suburban Infectious Disease Specialists SC Current Accepting new patients
Dr. Richard Aronoff, LTD PastSince Jun 18, 2009 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760514657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST",
            "address_2": "SUITE 308",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688412",
            "telephone_number": "847-699-1306",
            "fax_number": "847-299-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST",
            "address_2": "SUITE 308",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688412",
            "telephone_number": "847-699-1306",
            "fax_number": "847-299-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKER",
        "first_name": "ROBERTA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER #",
            "identifier": "01672647",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.