Provider Demographics
NPI:1538222708
Name:TALSKY, GERALD JOSEPH (LCSW)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:JOSEPH
Last Name:TALSKY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 N. LAKEVIEW AVENUE
Mailing Address - Street 2:#1807
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1813
Mailing Address - Country:US
Mailing Address - Phone:312-388-1262
Mailing Address - Fax:312-926-8713
Practice Address - Street 1:2626 N. LAKEVIEW AVE.
Practice Address - Street 2:#1807
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1813
Practice Address - Country:US
Practice Address - Phone:312-388-1262
Practice Address - Fax:312-926-8713
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical