Healthcare Provider Details

I. General information

NPI: 1720568199
Provider Name (Legal Business Name): GARY SPRING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2018
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E OGDEN AVE STE 129
HINSDALE IL
60521-3662
US

IV. Provider business mailing address

1S652 MACARTHUR DRIVE
OAKBROOK TERRACE IL
60181-4427
US

V. Phone/Fax

Practice location:
  • Phone: 630-935-7185
  • Fax:
Mailing address:
  • Phone: 630-935-7185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.011210
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: