NPI 1063028306

Jacob B Barack, PSYD

Practitioner Clinical Psychologist Park Ridge, IL

Practice location

Address: 1875 Dempster St STE 470, Park Ridge, IL 60068-1129
Phone: (847) 795-3100
Fax: (847) 723-5882
Mailing address: 29373 Network Pl, Chicago, IL 60673-1293

Registered specialties (2)

Clinical Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence 071.021063 (IL)

Other Psychologist providers in Illinois →

Clinical Psychologist

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence 0810007923 (VA)

Registry record

NPI: 1063028306
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Sep 2020
Record last updated: 22 Oct 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.