| Organization Name: | PSYCHOLOGICAL RESOURCE CENTER PC |
| NPI Number: | 1396856134 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARK IRA BORNSTEIN (OWNER PRESIDENT) |
| Mailing Address: | 175 Olde Half Day Rd Suite 140-2 Lincolnshire |
| State: | IL US |
| Postal Code: | 600693061 |
| Phone Number: | 7084612333 |
| Fax Number: | 7737512250 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 10/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 071004534 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |