Provider Demographics
NPI:1851474738
Name:ODONNELL, GREGORY L (LCSW)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:L
Last Name:ODONNELL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:19W181 18TH PLACE
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148
Mailing Address - Country:US
Mailing Address - Phone:847-946-5838
Mailing Address - Fax:630-682-5276
Practice Address - Street 1:222 E WILLOW AVE
Practice Address - Street 2:METROPOLITAN FAMILY SERVICES
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60145
Practice Address - Country:US
Practice Address - Phone:630-784-4810
Practice Address - Fax:630-682-5276
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical