Provider Demographics
NPI:1164172276
Name:SWIECKI, ERIC EUGENE (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:EUGENE
Last Name:SWIECKI
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 1:3314 N OAKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-8814
Mailing Address - Country:US
Mailing Address - Phone:773-550-5678
Mailing Address - Fax:
Practice Address - Street 1:3314 N OAKLEY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-8814
Practice Address - Country:US
Practice Address - Phone:773-550-5678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490218871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL149021887OtherSTATE OF ILLINOIS LICENSURE