Individual
DR. RICHARD NEAL BOLNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
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
Update your record
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