Provider Demographics
NPI:1255437513
Name:MARKS, DAVID MICHAEL (LCPC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:MARKS
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 1:1550 N NORTHWEST HWY STE 360
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1461
Mailing Address - Country:US
Mailing Address - Phone:847-299-3400
Mailing Address - Fax:224-985-2115
Practice Address - Street 1:1550 N NORTHWEST HWY STE 360
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1461
Practice Address - Country:US
Practice Address - Phone:847-299-3400
Practice Address - Fax:224-985-2115
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-002998101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health