Provider Demographics
NPI:1174043707
Name:GABOR, PRINCESS (MA, LPC)
Entity Type:Individual
Prefix:
First Name:PRINCESS
Middle Name:
Last Name:GABOR
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2545 W DIVERSEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-7172
Mailing Address - Country:US
Mailing Address - Phone:708-465-1293
Mailing Address - Fax:
Practice Address - Street 1:2545 W DIVERSEY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-7172
Practice Address - Country:US
Practice Address - Phone:708-465-1293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-24
Last Update Date:2017-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL$$$$$$$$$OtherPRIVATE INSURANCE/ MCO