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Individual

MR. JACQUES A. GOURGUECHON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
1454 W FARRAGUT AVE, CHICAGO, IL 60640-2104
(312) 203-9211
Mailing address
1454 W FARRAGUT AVE, CHICAGO, IL 60640-2104
(312) 203-9211

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.010830
IL

Other

Enumeration date
04/26/2015
Last updated
04/26/2015
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