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49 Sherwood Terrace Ste T Lake Bluff IL 60044 | |
| (847) 615-1425 | |
| (847) 615-1409 |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 49 Sherwood Terrace, Lake Bluff, Illinois |
| Authorized Official Name and Position | Gerard J Girdaukas (OWNER) |
| Authorized Official Contact | 8476151425 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 536 Lake Bluff IL 60044 Ph: (847) 615-1425 | 49 Sherwood Terrace Ste T Lake Bluff IL 60044 Ph: (847) 615-1425 |
| NPI Number | 1184847279 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184847279 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (Illinois) | Primary |
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