Healthcare Provider Details

I. General information

NPI: 1871418426
Provider Name (Legal Business Name): TIMOTHY LIAM GELLING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 S MICHIGAN AVE STE 1441
CHICAGO IL
60603-6173
US

IV. Provider business mailing address

122 S MICHIGAN AVE STE 1441
CHICAGO IL
60603-6173
US

V. Phone/Fax

Practice location:
  • Phone: 312-786-4990
  • Fax: 833-247-7198
Mailing address:
  • Phone: 312-786-4990
  • Fax: 833-247-7198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.022886
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: