Provider Demographics
NPI:1437288735
Name:GM PSYCHOLOGICAL SERVICES, INC.
Entity Type:Organization
Organization Name:GM PSYCHOLOGICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GILYOT-MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-750-3819
Mailing Address - Street 1:1108 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-1243
Mailing Address - Country:US
Mailing Address - Phone:773-750-3819
Mailing Address - Fax:708-383-6948
Practice Address - Street 1:1108 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-1243
Practice Address - Country:US
Practice Address - Phone:773-750-3819
Practice Address - Fax:708-383-6948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty