Richard N Bolnick PSYD & Associates PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071003331 Issued in IL

Legal business name

RICHARD N BOLNICK PSYD & ASSOCIATES PC

Practice address

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

Phone

(847) 549-6650

Fax

(847) 549-7005

NPI assigned

Apr 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Richard Neal Bolnick, PSYDNPI 1164402798

Title

President

Phone

(847) 549-6650

Specialties & licenses 1

Addresses

Other names 1

• RICHARD N BOLNICK PSYD & ASSOCIATES PC Other name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Neal Bolnick, PSYD

  • Clinical Psychologist
  • Vernon Hills, IL
  • NPI 1164402798
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1649496019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 LAKEVIEW PKWY 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": {
        "organization_name": "RICHARD N BOLNICK PSYD & ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "BOLNICK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "NEAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-549-6650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071003331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RICHARD N BOLNICK PSYD & ASSOCIATES PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• 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 Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.