Provider Demographics
NPI:1639222920
Name:HEALING GRACE COUNSELING, LTD.
Entity Type:Organization
Organization Name:HEALING GRACE COUNSELING, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:DEON
Authorized Official - Last Name:GILLHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:312-498-4113
Mailing Address - Street 1:800 W 5TH AVE
Mailing Address - Street 2:100G
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8965
Mailing Address - Country:US
Mailing Address - Phone:312-498-4113
Mailing Address - Fax:312-630-1342
Practice Address - Street 1:800 W 5TH AVE
Practice Address - Street 2:100G
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8965
Practice Address - Country:US
Practice Address - Phone:312-498-4113
Practice Address - Fax:312-630-1342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
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 - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2232522OtherBLUE CROSS BLUE SHIELD
IL2254200OtherCIGNA
IL266818OtherCOMPSYCH
IL266818OtherCOMPSYCH