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NPI Code Detail

MEDICARE: MR. JEFFREY W GILBERT MA, LPC

MEDICARE: MR. JEFFREY W GILBERT MA, LPC
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
1101YM0800XMental Health Counselor2177828556IL

General Provider Information

NPI Number : 1316219413
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JEFFREY W GILBERT MA, LPC
Provider Business Mailing Address
First Line : 6643 N NEWGARD AVE APT 3E
Second Line :
City : CHICAGO
State : IL
Zip : 60626-4743
Country : US
Telephone Number : 773-338-7740
Fax Number :
Provider Business Practice Location Address
First Line : 30 N MICHIGAN AVE STE 1920
Second Line :
City : CHICAGO
State : IL
Zip : 60602-3618
Country : US
Telephone Number : 773-338-7740
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2012
Last Update Date : 02/03/2012

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