Provider Demographics
NPI:1184847279
Name:ALLIED COUNSELING SERVICES PC
Entity Type:Organization
Organization Name:ALLIED COUNSELING SERVICES PC
Other - Org Name:GERARD GIRDAUKAS PHD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:GIRDAUKAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-615-1425
Mailing Address - Street 1:PO BOX 536
Mailing Address - Street 2:
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044
Mailing Address - Country:US
Mailing Address - Phone:847-615-1425
Mailing Address - Fax:847-615-1409
Practice Address - Street 1:49 SHERWOOD TERRACE
Practice Address - Street 2:STE T
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044
Practice Address - Country:US
Practice Address - Phone:847-615-1425
Practice Address - Fax:847-615-1409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty