Provider Demographics
NPI:1790859577
Name:SPIELMAN, GINA LEIGH (LCSW)
Entity type:Individual
Prefix:MS
First Name:GINA
Middle Name:LEIGH
Last Name:SPIELMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1869 WALSH DR
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560
Mailing Address - Country:US
Mailing Address - Phone:630-212-7048
Mailing Address - Fax:630-385-8570
Practice Address - Street 1:445 W JACKSON AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540
Practice Address - Country:US
Practice Address - Phone:630-212-7048
Practice Address - Fax:630-385-8570
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490078571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2232198OtherBCBS
7033332OtherAETNA