Provider Demographics
NPI:1790903102
Name:RORY GILBERT LCSW CADC LTD
Entity Type:Organization
Organization Name:RORY GILBERT LCSW CADC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MR
Authorized Official - First Name:RORY
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:847-272-7089
Mailing Address - Street 1:899 SKOKIE BOULEVARD
Mailing Address - Street 2:SUITE 430
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-4024
Mailing Address - Country:US
Mailing Address - Phone:847-272-7089
Mailing Address - Fax:847-681-9749
Practice Address - Street 1:899 SKOKIE BLVD
Practice Address - Street 2:SUITE 430
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-4019
Practice Address - Country:US
Practice Address - Phone:847-272-7089
Practice Address - Fax:847-681-9749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490014781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL205035Medicare PIN