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Individual

DR. RICHARD NEAL BOLNICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
977 LAKEVIEW PKWY, SUITE 110, VERNON HILLS, IL 60061-1400
(847) 549-6650
(847) 549-7005
Mailing address
977 LAKEVIEW PKWY, STE 110, VERNON HILLS, IL 60061-1400
(847) 549-6650
(847) 549-7005

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-003331
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4205873
AETNA PIN #
IL
01
459034000
MAGELLAN MIS #
IL
01
4932066
BC/BS PROVIDER #
IL
Enumeration date
01/19/2006
Last updated
05/20/2008
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