=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245642131
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GRUENER CONSULTING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/27/2014
-----------------------------------------------------
Last Update Date | 07/16/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1010 JORIE BLVD SUITE 112
-----------------------------------------------------
City | OAK BROOK
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60523-2215
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 872-216-5860
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 205 E BUTTERFIELD RD UNIT 284
-----------------------------------------------------
City | ELMHURST
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60126-5103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 872-216-5860
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CATHERINE AZ GRUENER
-----------------------------------------------------
Credential | LCPC
-----------------------------------------------------
Telephone | 872-216-5860
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 180009049
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------