person
Mr. Gerald Gene Odom SR.
Mental Health Counselor in Waukegan, Illinois
NPI 1548535966

Gerald Gene Odom SR. is a Mental Health Counselor based in Waukegan, IL and is specialized in Mental Health. Gerald Gene Odom SR. practices in Waukegan, IL. The NPI Number for Gerald Gene Odom SR. is 1548535966 and holds a License No. (Illinois).

The current practice location address for Gerald Gene Odom SR. is 3010 Grand Ave, Waukegan, IL and can be reached out via phone at 284-737-7868 and via fax at 847-377-8688.

Location: 3010 Grand Ave, Waukegan, IL, 60085-2321
person
Provider Profile Details
NPI Number
1548535966
Provider Name
Gerald Gene Odom SR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
3010 Grand Ave, Waukegan, IL, 60085-2321
Phone Number
284-737-7868
Fax Number
847-377-8688
Provider Enumeration Date
03/19/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3010 Grand Ave
City
State
Zip
60085-2321
Phone Number
284-737-7868
Fax Number
847-377-8688
person
Provider Business Mailing Address Details
Address
3010 Grand Ave
City
State
Zip
60085-2321
Phone Number
284-737-7868
Fax Number
847-377-8688
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
(Illinois)
Definition
Definition to come...
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