Healthcare Provider Details

I. General information

NPI: 1902286974
Provider Name (Legal Business Name): TERRY ANN DORNAK VILORIA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TERRY DORNAK PSYD

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 ORRINGTON AVE
EVANSTON IL
60201-3841
US

IV. Provider business mailing address

8941 MARMORA AVE
MORTON GROVE IL
60053-2448
US

V. Phone/Fax

Practice location:
  • Phone: 872-999-0542
  • Fax: 847-972-6445
Mailing address:
  • Phone: 872-999-0542
  • Fax: 847-972-6445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071009088
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: