Healthcare Provider Details

I. General information

NPI: 1871251124
Provider Name (Legal Business Name): GABRIELLE MARIE SCHILLER LPC, CTRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GABRIELLE MARIE COSTOUROS LPC, CTRS

II. Dates (important events)

Enumeration Date: 12/03/2021
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 S WEBSTER ST
NAPERVILLE IL
60540-5356
US

IV. Provider business mailing address

29 S WEBSTER ST
NAPERVILLE IL
60540-5356
US

V. Phone/Fax

Practice location:
  • Phone: 773-207-5721
  • Fax:
Mailing address:
  • Phone: 224-377-0701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178016876
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code225800000X
TaxonomyRecreation Therapist
License Number67996
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: