Provider Demographics
NPI:1457736993
Name:DAN GILL THERAPY LLC
Entity Type:Organization
Organization Name:DAN GILL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:GORDON
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:847-293-6290
Mailing Address - Street 1:1830 SHERMAN AVE
Mailing Address - Street 2:#406
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-3798
Mailing Address - Country:US
Mailing Address - Phone:847-293-6290
Mailing Address - Fax:
Practice Address - Street 1:1830 SHERMAN AVE
Practice Address - Street 2:#406
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3798
Practice Address - Country:US
Practice Address - Phone:847-293-6290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.004320251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health