Great Lakes Neuropsychology & Counseling Llc
Counselor Clinic
5758 Elaine Dr, Rockford
Illinois, 61108-3102
815-231-1280 815-231-1282
Maps & DirectionsGreat Lakes Neuropsychology & Counseling Llc is a Counselor Clinic in Rockford, Illinois. It is located at 5758 Elaine Dr, Rockford, IL and its contact number is 815-231-1280. The authorized person for Great Lakes Neuropsychology & Counseling Llc is Dr. Shaun A Bong
who is Licensed Clinical Psychologist/memb of the clinic and his/her contact number is 815-231-1280.
Great Lakes Neuropsychology & Counseling Llc Clinic has individuals who are licensure in clinical psychology and has done specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology. Neuropsychology is a specialty within the field of psychology focusing primarily on neurobehavioral functioning.
Complete Clinic Profile:
Great Lakes Neuropsychology & Counseling Llc Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Great Lakes Neuropsychology & Counseling Llc |
| Specialization: | Clinical Neuropsychologist |
| Clinic Address: | 5758 Elaine Dr, Rockford,
Illinois, 61108-3102 |
| Phone: | 815-231-1280 |
| Fax: | 815-231-1282 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Shaun A Bong |
| Position: | Licensed Clinical Psychologist/memb |
| Contact Number: | 815-231-1280 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Great Lakes Neuropsychology & Counseling Llc clinic are as mentioned below.
| NPI Number: | 1013030725 |
| NPI Enumeration Date: | 09 Apr, 2007 |
| NPI Last Update On: | 05 Feb, 2008 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Great Lakes Neuropsychology & Counseling Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Clinical | | Illinois | Primary | |
| Clinical Neuropsychologist | | Illinois | Secondary | |
| Clinical | | Illinois | Secondary | |
| Clinical Neuropsychologist | | Illinois | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 215368 | Other | Illinois | Medicare Ptan |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Great Lakes Neuropsychology & Counseling Llc
5758 Elaine Dr,
Rockford, Illinois |
| Zip: | 61108-3102 |
| Phone Number: | 815-231-1280 |
| Fax Number: | 815-231-1282 |
Patients can reach Great Lakes Neuropsychology & Counseling Llc at
5758 Elaine Dr, Rockford, Illinois or can
call to book an appointment on 815-231-1280.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.