Provider Demographics
NPI:1538143581
Name:GULINO, JANE MARGARET (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:MARGARET
Last Name:GULINO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E NORTHWEST HWY STE 212
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-1700
Mailing Address - Country:US
Mailing Address - Phone:847-358-0707
Mailing Address - Fax:847-854-5528
Practice Address - Street 1:1 E NORTHWEST HWY STE 212
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-1700
Practice Address - Country:US
Practice Address - Phone:847-358-0707
Practice Address - Fax:847-854-5528
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490003231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
L40826Medicare UPIN
L40826Medicare UPIN