Healthcare Provider Details

I. General information

NPI: 1164299533
Provider Name (Legal Business Name): DAVID FRANCIS SAXON LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2023
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5153 N CLARK ST STE 306
CHICAGO IL
60640-6850
US

IV. Provider business mailing address

1453 W ROSEMONT AVE APT 2W
CHICAGO IL
60660-0156
US

V. Phone/Fax

Practice location:
  • Phone: 312-690-3140
  • Fax:
Mailing address:
  • Phone: 412-304-7781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178.019663
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: