Healthcare Provider Details

I. General information

NPI: 1740706597
Provider Name (Legal Business Name): GABRIELA CORTINA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W LEA BLVD STE 202
WILMINGTON DE
19802-2545
US

IV. Provider business mailing address

4545 PULASKI AVE
LYONS IL
60534-1644
US

V. Phone/Fax

Practice location:
  • Phone: 302-204-7740
  • Fax:
Mailing address:
  • Phone: 773-517-3130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: