Provider Demographics
NPI:1093987604
Name:DONINGER, GRETCHEN L (PHD)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:L
Last Name:DONINGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E ONTARIO ST STE 1195
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3277
Mailing Address - Country:US
Mailing Address - Phone:312-640-7735
Mailing Address - Fax:312-988-9363
Practice Address - Street 1:211 E ONTARIO ST STE 1195
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3277
Practice Address - Country:US
Practice Address - Phone:312-640-7735
Practice Address - Fax:312-988-9363
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X, 103TC1900X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth