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NPI Code Detail

MEDICARE: GILBERT LICHSTEIN

MEDICARE:   GILBERT  LICHSTEIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor180.007218IL

General Provider Information

NPI Number : 1326520420
Entity Type Code : Individual
Provider Name (Legal Business Name) : GILBERT LICHSTEIN
Provider Business Mailing Address
First Line : 3204 EAGLE WAY
Second Line :
City : CHICAGO
State : IL
Zip : 60678-1032
Country : US
Telephone Number : 630-717-2258
Fax Number :
Provider Business Practice Location Address
First Line : 3828 W TAYLOR ST
Second Line :
City : CHICAGO
State : IL
Zip : 60624-4027
Country : US
Telephone Number : 773-826-1916
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2018
Last Update Date : 09/05/2018

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Directions to “ GILBERT LICHSTEIN ” Practice Location

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