Gray Therapeutics | |
1580 S Milwaukee Ave Libertyville IL 60048-3764 | |
(440) 714-8822 | |
Not Available |
Full Name | Gray Therapeutics |
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Speciality | Counselor - Mental Health |
Location | 1580 S Milwaukee Ave, Libertyville, Illinois |
Authorized Official Name and Position | David S Gray (PRESIDENT) |
Authorized Official Contact | 4407148822 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Gray Therapeutics 22072 W Engle Dr Lake Villa IL 60046-5411 Ph: () - | Gray Therapeutics 1580 S Milwaukee Ave Libertyville IL 60048-3764 Ph: (440) 714-8822 |
NPI Number | 1306306378 |
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Provider Enumeration Date | 03/25/2019 |
Last Update Date | 06/10/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306306378 | NPI | - | NPPES |
1649636077 | Other | IL | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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