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General NPI Number Information
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NPI Number | 1306398797
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Entity Type | Individual
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Provider Name | CHRISTI L GARDNER LCSW, CADC
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Gender | Female
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Dates
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Enumeration Date | 11/01/2016
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Last Update Date | 01/30/2017
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Provider Practice Location Address
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Address Line | 6033 N SHERIDAN RD
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City | CHICAGO
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State | IL
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Zip | 60660-3003
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Country | US
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Telephone | 773-793-5559
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Fax | 877-505-2823
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Provider Business Mailing Address
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Address Line | 6325 N SHERIDAN RD
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City | CHICAGO
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State | IL
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Zip | 60660-1749
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Country | US
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Telephone | 773-793-5559
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 31900
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149018427
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License Number State | IL
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