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General NPI Number Information
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NPI Number | 1235822156
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Entity Type | Individual
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Provider Name | D'ANGELO STARKS LCSW
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Gender | Male
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 1500 W CHICAGO AVE
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City | CHICAGO
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State | IL
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Zip | 60642-5236
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Country | US
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Telephone | 773-614-6958
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 W CHICAGO AVE
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City | CHICAGO
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State | IL
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Zip | 60642-5236
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Country | US
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Telephone | 773-614-6958
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.030966
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License Number State | IL
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