| Doctor Name: | MONA D. FISHBANE |
| NPI Number: | 1073720637 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 071004171 |
| Business Practice Address: | 1803 Saint Johns Ave Highland Park, IL - 600353298 |
| Business Phone Number: | 8474322096 |
| Business Fax Number: | |
| Mailing Address: | 1803 Saint Johns Ave, HIGHLAND PARK |
| State: | IL |
| Postal Code: | 600353298 |
| Phone Number: | 8474322096 |
| Fax Number: | |
| NPI Enumeration Date: | 05/16/2007 |
| NPI Last Update Date: | 04/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 071004171 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |