Organization
PSYCHOLOGICAL RESOURCE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK IRA BORNSTEIN PSYD (OWNER PRESIDENT)
(708) 461-2333
Entity
Organization
Contact information
Practice address
175 OLDE HALF DAY RD, SUITE 140-2, LINCOLNSHIRE, IL 60069-3061
(708) 461-2333
(773) 751-2250
Mailing address
46 CUMBERLAND DR, LINCOLNSHIRE, IL 60069
(708) 461-2333
(847) 267-8015
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071004534
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4932021
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/31/2006
Last updated
10/06/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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