Provider Demographics
NPI:1962740753
Name:REICH, GAIL
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:REICH
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 1:833 W BUENA AVE APT 806
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-6606
Mailing Address - Country:US
Mailing Address - Phone:201-919-2469
Mailing Address - Fax:
Practice Address - Street 1:900 NORTH SHORE DR
Practice Address - Street 2:SUITE 120
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-2243
Practice Address - Country:US
Practice Address - Phone:201-919-2469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor