Individual
DENNIS KLACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., LCPC, NCC
Contact information
Practice address
10725 S WESTERN AVE, CHICAGO, IL 60643-3135
(630) 686-2015
Mailing address
40 E 9TH ST APT 1901, CHICAGO, IL 60605-2152
(630) 686-2015
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
178.011630
IL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
180012441
IL
Other
Enumeration date
03/29/2016
Last updated
10/27/2019
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