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NPI Code Detail

MEDICARE: MR. FRITZ G GELIN CADC

MEDICARE: MR. FRITZ G GELIN 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
1101YP2500XProfessional Counselor180.011479IL
2101YA0400XAddiction (Substance Use Disorder) Counselor27810IL

General Provider Information

NPI Number : 1093003469
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. FRITZ G GELIN CADC
Provider Business Mailing Address
First Line : 2025 WASHINGTON ST
Second Line :
City : WAUKEGAN
State : IL
Zip : 60085-5131
Country : US
Telephone Number : 847-360-1020
Fax Number : 847-360-1065
Provider Business Practice Location Address
First Line : 2025 WASHINGTON ST
Second Line :
City : WAUKEGAN
State : IL
Zip : 60085-5131
Country : US
Telephone Number : 847-360-1020
Fax Number : 847-360-1065
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2011
Last Update Date : 04/15/2024

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