Russell, Gay

Russell, Gay is an individual health care provider with primary practice located at 148 S Bloomingdale Rd Suite 112, Bloomingdale IL 60108. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Russell, Gay can be contacted via phone (630) 894-4451.

Contact Information

Primary practice address
148 S Bloomingdale Rd Suite 112 Bloomingdale IL 60108
Phone: (630) 894-4451
Fax: (630) 894-2876
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149011209 Illinois

Profile Details

NPI number 1013039502
LBN Legal business name Russell, Gay
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2007
Last updated Nov 5th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013039502 NPPES
Illinois Other 02221520 BCBS

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