Provider Demographics
NPI:1053832618
Name:ECK, DANIEL KENNETH (LCPC)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:KENNETH
Last Name:ECK
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 N HARBOR DR APT 313
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7733
Mailing Address - Country:US
Mailing Address - Phone:217-299-1701
Mailing Address - Fax:
Practice Address - Street 1:1300 W BELMONT AVE STE 504
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3242
Practice Address - Country:US
Practice Address - Phone:217-299-1701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-04
Last Update Date:2017-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.010606101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor