Provider Demographics
NPI:1730822941
Name:PATRICK GEHRLICH PLLC
Entity type:Organization
Organization Name:PATRICK GEHRLICH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:GEHRLICH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:513-593-0663
Mailing Address - Street 1:4007 N BROADWAY ST STE 209
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-6076
Mailing Address - Country:US
Mailing Address - Phone:513-593-0663
Mailing Address - Fax:773-439-5683
Practice Address - Street 1:4007 N BROADWAY ST STE 209
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-6076
Practice Address - Country:US
Practice Address - Phone:513-593-0663
Practice Address - Fax:773-439-5683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health