MEDICARE: GAIL RICHMAN

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
1	101Y00000X	Counselor	180007984	IL

General Provider Information

NPI Number	:	1982980116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL RICHMAN

Provider Business Mailing Address
First Line	:	25 EAST WASHINGTON
Second Line	:	SUITE 1826
City	:	CHICAGO
State	:	IL
Zip	:	60602-1708
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25 E WASHINGTON ST
Second Line	:	SUITE 1826
City	:	CHICAGO
State	:	IL
Zip	:	60602-1708
Country	:	US
Telephone Number	:	312-445-9377
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2011
Last Update Date	:	11/02/2011

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Directions to “ GAIL RICHMAN ” Practice Location

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