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NPI Code Detail

MEDICARE: DR. JAMES THOMAS GRESH

MEDICARE:  DR. JAMES THOMAS GRESH
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
1103TC0700XClinical Psychologist071010894IL
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1316654270
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAMES THOMAS GRESH
Provider Business Mailing Address
First Line : 333 N MICHIGAN AVE STE 2400
Second Line :
City : CHICAGO
State : IL
Zip : 60601-4040
Country : US
Telephone Number : 773-609-0361
Fax Number : 301-896-5595
Provider Business Practice Location Address
First Line : 333 N MICHIGAN AVE STE 2400
Second Line :
City : CHICAGO
State : IL
Zip : 60601-4040
Country : US
Telephone Number : 773-609-0361
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2022
Last Update Date : 10/05/2024

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Directions to “ DR. JAMES THOMAS GRESH ” Practice Location

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