Provider Demographics
NPI:1669713475
Name:BIALKOWSKI, GEORGE KAROL (PSYD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:KAROL
Last Name:BIALKOWSKI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 N MILL ST STE 101
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-6305
Mailing Address - Country:US
Mailing Address - Phone:630-473-3971
Mailing Address - Fax:
Practice Address - Street 1:2132 DEEP WATER LN STE 212B
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8498
Practice Address - Country:US
Practice Address - Phone:630-473-3971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071009240103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist