Provider Demographics
NPI:1770467128
Name:GIPSON, MONIQUE D (MD)
Entity type:Individual
Prefix:DR
First Name:MONIQUE
Middle Name:D
Last Name:GIPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3235 VOLLMER RD STE 119
Mailing Address - Street 2:
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-2040
Mailing Address - Country:US
Mailing Address - Phone:708-914-2005
Mailing Address - Fax:
Practice Address - Street 1:3235 VOLLMER RD STE 119
Practice Address - Street 2:
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2040
Practice Address - Country:US
Practice Address - Phone:708-914-2005
Practice Address - Fax:708-914-2008
Is Sole Proprietor?:No
Enumeration Date:2025-07-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health