Healthcare Provider Details

I. General information

NPI: 1386155943
Provider Name (Legal Business Name): DK THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 S MICHIGAN AVE STE 928
CHICAGO IL
60605-1399
US

IV. Provider business mailing address

410 S MICHIGAN AVE STE 928
CHICAGO IL
60605-1399
US

V. Phone/Fax

Practice location:
  • Phone: 312-248-3190
  • Fax:
Mailing address:
  • Phone: 312-248-3190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DANIELLE KEPLER
Title or Position: OWNER
Credential:
Phone: 312-248-3190