Healthcare Provider Details

I. General information

NPI: 1386877660
Provider Name (Legal Business Name): D G COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 07/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 MAPLE AVE
DOWNERS GROVE IL
60515-4928
US

IV. Provider business mailing address

1001 MAPLE AVE
DOWNERS GROVE IL
60515-4928
US

V. Phone/Fax

Practice location:
  • Phone: 630-353-0697
  • Fax: 630-353-0697
Mailing address:
  • Phone: 630-353-0697
  • Fax: 630-353-0697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180-004746
License Number StateIL

VIII. Authorized Official

Name: DR. DONNA J GLUCK
Title or Position: PRESIDENT
Credential: EDD, LCPC
Phone: 630-353-0697