Most Relevant Information
Provider Data
| NPI Number: | 1003599077 |
| Provider Name: | NICHOLAS PRESTON BARRY LSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/08/2023 |
| Last Updated: | 02/08/2024 |
Provider Practice Location
411 W RIVER RD
ELGIN
IL
601231570
Practice Location Phone/Fax
| Phone: | 2243474011 |
| Fax: |
Provider Mailing Location
16730 BEVERLY AVE
TINLEY PARK
IL
604772951
Provider Mailing Phone/Fax
| Phone: | 7085173120 |
| Fax: |