Provider Demographics
NPI:1356856918
Name:TAYLOR, GERALDINE (MSW-CADC-MISA-I)
Entity type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSW-CADC-MISA-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 S KOSTNER AVE STE 500
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-1100
Mailing Address - Country:US
Mailing Address - Phone:773-224-7386
Mailing Address - Fax:773-224-7685
Practice Address - Street 1:7601 S KOSTNER AVE STE 500
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-1100
Practice Address - Country:US
Practice Address - Phone:773-224-7386
Practice Address - Fax:773-224-7685
Is Sole Proprietor?:No
Enumeration Date:2017-12-05
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)