Healthcare Provider Details

I. General information

NPI: 1235516162
Provider Name (Legal Business Name): DAVID ANTHONY EFKEN M.A., LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 05/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HART RD SUITE 201
BARRINGTON IL
60010-2659
US

IV. Provider business mailing address

1000 HART RD SUITE 201
BARRINGTON IL
60010-2659
US

V. Phone/Fax

Practice location:
  • Phone: 847-382-4673
  • Fax: 847-382-1915
Mailing address:
  • Phone: 847-382-4673
  • Fax: 847-382-1915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.009703
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: