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General NPI Number Information
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NPI Number | 1548242753
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Entity Type | Individual
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Provider Name | WILLIAM DAVID GIESEKE PH.D.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 09/25/2023
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Provider Practice Location Address
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Address Line | 1850 OAK STREET SUITE 240
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City | NORTHFIELD
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State | IL
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Zip | 60093-3028
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Country | US
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Telephone | 847-446-0240
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Fax |
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Provider Business Mailing Address
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Address Line | 788 W FRONTAGE ROAD SUITE 122
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City | NORTHFIELD
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State | IL
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Zip | 60093-1209
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Country | US
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Telephone | 847-446-0240
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180-002489
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180-002489
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License Number State | IL
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