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NPI Code Detail

MEDICARE: MICHELLE D GEBHARDT PSYD

MEDICARE: MICHELLE D GEBHARDT PSYD
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 Psychologist071-007810IL

General Provider Information

NPI Number : 1891014429
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE D GEBHARDT PSYD
Provider Business Mailing Address
First Line : 333 N MICHIGAN AVE STE 1900
Second Line :
City : CHICAGO
State : IL
Zip : 60601-3994
Country : US
Telephone Number : 773-321-2831
Fax Number : 312-540-9944
Provider Business Practice Location Address
First Line : 333 N MICHIGAN AVE STE 1900
Second Line :
City : CHICAGO
State : IL
Zip : 60601-3994
Country : US
Telephone Number : 773-321-2837
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2010
Last Update Date : 03/17/2018

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Directions to “ MICHELLE D GEBHARDT PSYD” Practice Location

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