Provider Demographics
NPI:1417471178
Name:KASPER-MACMILLAN, DANIEL LEE (LCPC,LPCC,LPC,IMHP)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LEE
Last Name:KASPER-MACMILLAN
Suffix:
Gender:M
Credentials:LCPC,LPCC,LPC,IMHP
Other - Prefix:
Other - First Name:DANIEL
Other - Middle Name:LEE
Other - Last Name:MCMILLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC, LPC, IMHP
Mailing Address - Street 1:5724 N LOWELL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5926
Mailing Address - Country:US
Mailing Address - Phone:260-316-9713
Mailing Address - Fax:
Practice Address - Street 1:225 N MICHIGAN AVE STE 1430
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7653
Practice Address - Country:US
Practice Address - Phone:312-971-3457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178010844101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor