Individual
MR. EDGAR ALEXANDER BARRIOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PEDORTHIST
Contact information
Practice address
307 W SAINT PAUL ST, SPRING VALLEY, IL 61362-1860
(312) 315-6584
Mailing address
702 JUSTINA ST, HINSDALE, IL 60521-2425
(312) 315-6584
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
212000132
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212000132
ILLINOIS LICENSE
IL
Enumeration date
06/25/2018
Last updated
06/25/2018
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