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General NPI Number Information
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NPI Number | 1215539085
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Entity Type | Organization
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Legal Business Name | GAYL M. MONTO, LLC
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 2530 CRAWFORD AVE STE 201
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City | EVANSTON
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State | IL
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Zip | 60201-4959
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Country | US
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Telephone | 847-971-1090
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Fax | 847-241-0305
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Provider Business Mailing Address
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Address Line | 2530 CRAWFORD AVE STE 201
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City | EVANSTON
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State | IL
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Zip | 60201-4959
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Country | US
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Telephone | 847-971-1090
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Fax | 847-241-0305
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Authorized Official
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Title or Position | OWNER/LCSW
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Name | GAYL M MONTO
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Credential | LCSW
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Telephone | 847-971-1090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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