Gurinder Bolina, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.008437 Issued in IL

Practice address

175 E Hawthorne Pkwy
Ste 235
Vernon Hills, IL 60061-1463

Phone

(847) 868-3435

Fax

(847) 859-5885

NPI assigned

Jun 17, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Vicki Banga Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.gurinderbolina@146897.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Edgewood Clinical Services, P.C.

  • Psychologist
  • Naperville, IL
  • NPI 1295914646
  Medicare reassignment NPD
• PHC of Buffalo Grove Nutrition

  • Registered Dietitian
  • Vernon Hills, IL
  • NPI 1902107386
  NPD (past)
• Psychology Specialists LTD

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1053368605
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1083841951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E HAWTHORNE PKWY",
            "address_2": "STE 235",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611463",
            "telephone_number": "847-868-3435",
            "fax_number": "847-859-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E HAWTHORNE PKWY",
            "address_2": "STE 235",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611463",
            "telephone_number": "847-868-3435",
            "fax_number": "847-859-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLINA",
        "first_name": "GURINDER",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "04674",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.008437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKI",
            "last_name": "BANGA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle Rene Bleashka
• Alissa E Block-Rissman, D.O.
• Patrick James Bloom, OTR/L
• Steven J Bloomfield, LPC
• Rachel Leah Blumenthal, C.N.M.
• Richard Neal Bolnick, PSYD
• Bon Vie Therapy LLC
• Susan Bonnem
• Courtney Grayce Bosco, M.S. CFY/SLP
• Michael R Bourbon, LCSW

• Clinical Psychologist in Vernon Hills, IL
• Providers in Vernon Hills, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.