Provider Demographics
NPI:1083841951
Name:BOLINA, GURINDER (PHD)
Entity Type:Individual
Prefix:DR
First Name:GURINDER
Middle Name:
Last Name:BOLINA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:VICKI
Other - Middle Name:
Other - Last Name:BANGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:175 E HAWTHORNE PKWY
Mailing Address - Street 2:STE 235
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1463
Mailing Address - Country:US
Mailing Address - Phone:847-868-3435
Mailing Address - Fax:847-859-5885
Practice Address - Street 1:175 E HAWTHORNE PKWY
Practice Address - Street 2:STE 235
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1463
Practice Address - Country:US
Practice Address - Phone:847-868-3435
Practice Address - Fax:847-859-5885
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD046742084P0804X
IL071.008437103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry