Healthcare Provider Details

I. General information

NPI: 1437547858
Provider Name (Legal Business Name): MARC GENSON LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2015
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E OGDEN AVE STE 304
WESTMONT IL
60559-5554
US

IV. Provider business mailing address

700 E OGDEN AVE STE 304
WESTMONT IL
60559-5554
US

V. Phone/Fax

Practice location:
  • Phone: 847-232-4535
  • Fax:
Mailing address:
  • Phone: 847-232-4616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180009487
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: