Individual
MS. MELODY BATHER-GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MISA II
Contact information
Practice address
2020 W HARRISON ST, 226, CHICAGO, IL 60612-3741
(312) 572-4518
(312) 572-4518
Mailing address
2020 W HARRISON ST, CHICAGO, IL 60612-3741
(312) 572-4518
(312) 572-4518
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19258
IAODAPCA
IL
Enumeration date
03/04/2008
Last updated
03/04/2008
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