Individual
ERIC BORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SCHOOL PSYCHOLOGIST
Contact information
Practice address
1600 EAGLE WAY, LAKE VILLA, IL 60046-7477
(847) 838-7109
Mailing address
1600 EAGLE WAY, LAKE VILLA, IL 60046-7477
(847) 838-7109
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
869241
IL
Other
Enumeration date
05/10/2019
Last updated
05/10/2019
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