Provider Demographics
NPI:1679791255
Name:GERSTEN & ASSOCIATES
Entity type:Organization
Organization Name:GERSTEN & ASSOCIATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:GERSTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-329-9210
Mailing Address - Street 1:675 W NORTH AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:MELROSE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60160-1634
Mailing Address - Country:US
Mailing Address - Phone:708-681-9210
Mailing Address - Fax:708-681-9280
Practice Address - Street 1:675 W NORTH AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-1634
Practice Address - Country:US
Practice Address - Phone:708-681-9210
Practice Address - Fax:708-681-9280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Single Specialty