Provider Demographics
NPI:1104130111
Name:GILLETT, JANET
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:GILLETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6954 N GREENVIEW AVE
Mailing Address - Street 2:APT 409
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-3458
Mailing Address - Country:US
Mailing Address - Phone:802-309-4301
Mailing Address - Fax:
Practice Address - Street 1:1201 S CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60608-1013
Practice Address - Country:US
Practice Address - Phone:312-746-5905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor