Provider Demographics
NPI:1073813002
Name:GELB, HOWARD MICHAEL (LCSW, CADC)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:MICHAEL
Last Name:GELB
Suffix:
Gender:M
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 W MELROSE ST
Mailing Address - Street 2:207
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3845
Mailing Address - Country:US
Mailing Address - Phone:773-248-1009
Mailing Address - Fax:
Practice Address - Street 1:4007 N BROADWAY ST
Practice Address - Street 2:207
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-6074
Practice Address - Country:US
Practice Address - Phone:773-248-1009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-25
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0173341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical