Organization
CAROLYN GUERRA BURNS PSYD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROLYN GUERRA BURNS PSY.D (CLINICAL PSYCHOLOGIST)
(708) 790-4062
Entity
Organization
Contact information
Practice address
200 RAVINIA AVE., ORLAND PARK, IL 60462
(708) 460-1212
Mailing address
44 OAK CREEK DR., BURR RIDGE, IL 60527
(708) 790-4062
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
071-6747
IL
103TC0700X
Clinical Psychologist
Primary
071-006747
IL
103TC2200X
Clinical Child & Adolescent Psychologist
071-006747
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635321
BLUECROSS BLUE SHIELD
IL
Enumeration date
12/13/2006
Last updated
09/03/2014
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