Individual
ILANA GONIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-2172
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-2172
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
071008019
IL
Other
Enumeration date
03/10/2011
Last updated
03/10/2011
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