Individual
DR. COURTNEY RACQUEL CORNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
5000 S 5TH AVE, HINES VA HOSPITAL/ BLDG 128 RM A114, HINES, IL 60141-3030
(708) 202-8387
Mailing address
664 LAKEWOOD FARMS DR, BOLINGBROOK, IL 60490-3164
(630) 310-9472
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3422-57
WI
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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