DENNIS KLACKO (NPI# 1295198141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295198141 |
| Entity Type | Individual |
| Full Name | DENNIS KLACKO |
| Credential | M.A., LCPC, NCC |
| Practice Address |
10725 S Western Ave Chicago IL 60643-3135 |
| Mailing Address |
40 E 9th St Apt 1901 Chicago IL 60605-2152 |
| Practice Telephone | 6306862015 |
| Mailing Telephone | 6306862015 |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2019-10-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 178.011630 | IL | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
180012441 | IL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1909 Cheker Sq, East Hazel Crest, IL 604291442 | 7086473303 |
| Street Address |
10725 S WESTERN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60643-3135 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306866132 | Patricia Joan Harthun | Counselor | 10725 S Western Ave, 2nd Floor, Chicago, IL 60643-3135 | 2006-07-21 |
| 1205474475 | New Directions Therapy, Ltd. | Community/Behavioral Health | 10725 S Western Ave, Chicago, IL 60643-3217 | 2019-12-18 |
| 1841836962 | Love Yogaself Therapy LLC | Community/Behavioral Health | 10725 S Western Ave, Chicago, IL 60643-3135 | 2019-11-24 |
| 1982249850 | Chrysanthemum Counseling, Ltd | Social Worker | 10725 S Western Ave, Chicago, IL 60643-3135 | 2019-11-14 |
| 1972002483 | James Thomas Peltzer II | Counselor | 10725 S Western Ave, Chicago, IL 60643-3135 | 2018-02-09 |
| 1275075632 | Pete Hardy | Counselor | 10725 S Western Ave, Chicago, IL 60643-3135 | 2016-11-15 |
| 1841741048 | Shavaughn Carey | Social Worker | 10725 S Western Ave, Chicago, IL 60643-3135 | 2016-10-23 |
| 1316498561 | Basarida Wellness, LLC | Social Worker | 10725 S Western Ave, 2nd Floor, Chicago, IL 60643-3135 | 2016-10-21 |
| 1710360458 | Patricia Harthun Lcpc Ltd | Counselor | 10725 S Western Ave, 2nd Floor, Chicago, IL 60643-3135 | 2015-06-30 |
| 1669867289 | Bonnie Wade | Social Worker | 10725 S Western Ave, 2nd Floor, Chicago, IL 60643-3135 | 2015-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154941698 | Breann Hampton | Behavior Technician | 1214 W 115th St, Chicago, IL 60643 | 2020-04-24 |
| 1366075566 | Sanctuary Counseling, LLC | Home Health | 12247 S Racine Ave, Calumet Park, IL 60643 | 2020-02-16 |
| 1467082883 | Juliana Frances Cunningham | Developmental Therapist | 10037 S Bell, Chicago, IL 60643 | 2020-01-24 |
| 1013578624 | Sct Counseling | Counselor | 11948 S Western Ave, Chicago, IL 60643 | 2019-06-25 |
| 1073087474 | For Eyes Optical Company of Pa | Optometrist | 9900 S Ridgleland Ave, Chicago Ridge, IL 60643 | 2019-01-18 |
| 1073096426 | Derek Peake | Physical Therapist | 9465 S. Western Road, Chicago, IL 60643 | 2018-09-12 |
| 1508356072 | Halo Medical Professionals Sc. | Chiropractor | 10650 S Western Ave, Chicago, IL 60643 | 2018-05-10 |
| 1811405699 | Kara Eileen Noland | Developmental Therapist | 9327 S Hamilton Ave, Chicago, IL 60643 | 2018-01-16 |
| 1588173546 | Kiah Nicole Bouie | Behavioral Analyst | 1461 W 113th Pl, Chicago, IL 60643 | 2017-09-21 |
| 1174042766 | Travis Wade Robertson | Physical Therapist | 10909-11 S Western Ave, Beverly, IL 60643 | 2017-09-14 |
| Find all providers in zip 60643 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071932 | Euginia Ivanova | Counselor | 3410 W. Roosevelt Rd, Chicago, IL 60624 | 2020-10-19 |
| 1073127775 | Deborah Lynn Dettman | Counselor | 1209 W Sherwin Ave Apt 809, Chicago, IL 60626-2257 | 2020-09-01 |
| 1538705793 | Andrew W Rintels | Counselor | C/o Madden, Jiganti, Moore & Sinars LLP, 190 South Lasalle Street, Suite 1700, Chicago, IL 60603 | 2019-11-22 |
| 1710528518 | Gateway Professional Services, PC | Counselor | 55 E Jackson Blvd Ste 1500, Chicago, IL 60604-4184 | 2019-10-02 |
| 1801447552 | Erika Chawla | Counselor | 1658 N Milwaukee Ave # 8253, Chicago, IL 60647-6905 | 2019-09-24 |
| 1336790310 | Robert J Smith | Counselor | 2544 W Irving Park Rd Apt 1e, Chicago, IL 60618-3752 | 2019-09-22 |
| 1255997987 | Austin Hall | Counselor | 2942 W Lake St, Chicago, IL 60612-1924 | 2019-05-17 |
| 1417418914 | Monica Connelly | Counselor | 800 N Lake Shore Dr Ste 800, Chicago, IL 60611-2402 | 2019-03-27 |
| 1336608439 | Columbus Manor | Counselor | 5107 W Jackson Blvd, Chicago, IL 60644-4316 | 2019-03-18 |
| 1972062958 | Patricia B Flaherty | Counselor | 210 S Desplaines St Apt 1407, Chicago, IL 60661-5570 | 2019-03-18 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.