Provider Demographics
NPI:1194146852
Name:CHEEKS, GINA
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:CHEEKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:DECARLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:441 COURTESY LN
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-5509
Mailing Address - Country:US
Mailing Address - Phone:847-452-0877
Mailing Address - Fax:630-717-1165
Practice Address - Street 1:1288 RICKETT DRIVE
Practice Address - Street 2:SUITE 220
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540
Practice Address - Country:US
Practice Address - Phone:847-452-0877
Practice Address - Fax:630-717-1165
Is Sole Proprietor?:No
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490159681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical