Richard Neal Bolnick, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-003331 Issued in IL

Practice address

977 Lakeview Pkwy
Suite 110
Vernon Hills, IL 60061-1400

Phone

(847) 549-6650

Fax

(847) 549-7005

NPI assigned

Jan 19, 2006

Last updated

May 20, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

Clinical Psychologist

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Richard N Bolnick PSYD & Associates PC

  • Clinical Psychologist
  • Vernon Hills, IL
  • NPI 1649496019
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1164402798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 LAKEVIEW PKWY",
            "address_2": "STE 110",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611400",
            "telephone_number": "847-549-6650",
            "fax_number": "847-549-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 LAKEVIEW PKWY",
            "address_2": "SUITE 110",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611400",
            "telephone_number": "847-549-6650",
            "fax_number": "847-549-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLNICK",
        "first_name": "RICHARD",
        "middle_name": "NEAL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-003331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER #",
            "identifier": "4932066",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN #",
            "identifier": "4205873",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN MIS #",
            "identifier": "459034000",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alissa E Block-Rissman, D.O.
• Patrick James Bloom, OTR/L
• Steven J Bloomfield, LPC
• Rachel Leah Blumenthal, C.N.M.
• Gurinder Bolina, PHD
• Bon Vie Therapy LLC
• Susan Bonnem
• Courtney Grayce Bosco, M.S. CFY/SLP
• Michael R Bourbon, LCSW
• Christine Marie Bowman, DC

• 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 May 20, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.