Doctor Name: | DR. BENJAMIN MICHAEL GESING |
NPI Number: | 1669870747 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSYD |
License Number: | 071.008934 |
Business Practice Address: | 2474 Knowlton Dr West Dundee, IL - 601183530 |
Business Phone Number: | 7044088897 |
Business Fax Number: | |
Mailing Address: | 2474 Knowlton Dr, WEST DUNDEE |
State: | IL |
Postal Code: | 601183530 |
Phone Number: | 7044088897 |
Fax Number: | |
NPI Enumeration Date: | 12/05/2014 |
NPI Last Update Date: | 12/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 071.008934 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |