Provider Demographics
NPI:1568823615
Name:HARKI, MAGDALENE RENE (PSYD ABPP)
Entity type:Individual
Prefix:
First Name:MAGDALENE
Middle Name:RENE
Last Name:HARKI
Suffix:
Gender:F
Credentials:PSYD ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 W DEMPSTER ST STE 690
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1180
Mailing Address - Country:US
Mailing Address - Phone:847-723-7965
Mailing Address - Fax:
Practice Address - Street 1:1875 W DEMPSTER ST STE 690
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1180
Practice Address - Country:US
Practice Address - Phone:847-723-7965
Practice Address - Fax:847-723-7599
Is Sole Proprietor?:No
Enumeration Date:2016-03-17
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.010071103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist