Dianna W Bolen is a Clinical in Chicago, Illinois. Dianna W Bolen practices all healthcare services and medical treatments related to Clinical. The NPI Number for Dianna W Bolen is 1417089293. The last update date is 2009-06-29.
Dianna W Bolen's current location address is 4350 N Hermitage Ave, Chicago, Illinois. You can contact this provider via phone number 7733279356 and fax number 7733488220. The mailing address for Dianna W Bolen is 4350 N Hermitage Ave, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
Provider Name | Dianna W Bolen |
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Address | 4350 N Hermitage Ave, Chicago, Illinois |
Phone Number | 7733279356 |
Fax Number | 7733488220 |
Sole Proprietor | Y |
Credentials | PSYD |
NPI Number Detail
NPI Number | 1417089293 |
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Provider Enumeration Date | 2007-03-09 |
Last Updated Date | 2009-06-29 |
Provider Mailing Address Detail
Address | 4350 N Hermitage Ave |
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City | Chicago |
State | Illinois (IL) |
Post Code | 606131106 |
Phone Number | 7733279356 |
Fax Number | 7733488220 |
Provider's Primary Taxonomy Detail
Speciality | Clinical |
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Taxonomy | 103Tc0700X |
Licence No | 71006419 |
Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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1632869 | IL | BCBS |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Dianna W Bolen by the Centers for Medicare & Medicaid Services?
The Dianna W Bolen has been issued the NPI (National Provider Identifier) 1417089293, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Dianna W Bolen?
The Dianna W Bolen is situated at 4350 N Hermitage Ave, in the city of Chicago, state of IL, with the zip code 606131106.
What is the Dianna W Bolen's area of specialization and corresponding taxonomy classification?
The Dianna W Bolen's specialty field is Clinical, and it falls under the taxonomy code 103Tc0700X, which categorizes healthcare providers based on their specialties.
On what date did Dianna W Bolen receive its 1417089293 assignment from the Centers for Medicare & Medicaid Services?
The Dianna W Bolen was assigned its 1417089293 on 2007-03-09, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Dianna W Bolen most recently updated or revised?
The information pertaining to Dianna W Bolen, including its address, specialty, and other relevant details, was last updated or revised on 2009-06-29.
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