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Individual

GILBERT LICHSTEIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3828 W TAYLOR ST, CHICAGO, IL 60624-4027
(773) 826-1916
Mailing address
3204 EAGLE WAY, CHICAGO, IL 60678-1032
(630) 717-2258

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180.007218
IL

Other

Enumeration date
09/05/2018
Last updated
09/05/2018
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