Provider Demographics
NPI:1902221203
Name:BERNS-ZARE, ILENE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ILENE
Middle Name:
Last Name:BERNS-ZARE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3248 N VOLZ DR E
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1642
Mailing Address - Country:US
Mailing Address - Phone:847-309-6373
Mailing Address - Fax:
Practice Address - Street 1:3248 N VOLZ DR E
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1642
Practice Address - Country:US
Practice Address - Phone:847-309-6373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-23
Last Update Date:2014-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.006127103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical