MEDICARE: GIGI LEGEIA FULLER CADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	22296	IL

General Provider Information

NPI Number	:	1053260927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIGI LEGEIA FULLER CADC

Provider Business Mailing Address
First Line	:	601 S 3RD AVE
Second Line	:
City	:	MAYWOOD
State	:	IL
Zip	:	60153-2232
Country	:	US
Telephone Number	:	312-493-5990
Fax Number	:	312-493-5990

Provider Business Practice Location Address
First Line	:	601 S 3RD AVE
Second Line	:
City	:	MAYWOOD
State	:	IL
Zip	:	60153-2232
Country	:	US
Telephone Number	:	312-493-5990
Fax Number	:	312-493-5990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2026
Last Update Date	:	01/24/2026

Similar Medicare Providers

1902471683 — DR. THANCHANOK CHAIPRASIT M.D.
Practice Location Address:

2160 S. FIRST AVE
MAYWOOD, IL
60153

Practice Phone: 708-327-2626
Practice Fax:

1669331062 — ANDREW JAMES GAETANO
Practice Location Address:

2160 S 1ST AVE
MAYWOOD, IL
60153-3328

Practice Phone: 708-216-3229
Practice Fax:

1508725706 — GRIFFIN KYLE JOHNSON
Practice Location Address:

2160 S 1ST AVE
MAYWOOD, IL
60153-3328

Practice Phone: 888-584-7888
Practice Fax:

1124406343 — DR. ERIN ALYSE STRONG MD
Practice Location Address:

2160 S 1ST AVE
MAYWOOD, IL
60153-3328

Practice Phone: 888-584-7888
Practice Fax:

1386593317 — KIANA ELAINE KING
Practice Location Address:

2160 S 1ST AVE
MAYWOOD, IL
60153-3328

Practice Phone: 888-584-7888
Practice Fax:

1366459562 — DR. VLADIMIR VIDANOVIC M.D.
Practice Location Address:

2160 S 1ST AVE # EMS2280
MAYWOOD, IL
60153-3328

Practice Phone: 708-327-2689
Practice Fax: 312-704-2737

Directions to “ GIGI LEGEIA FULLER CADC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.