Provider Demographics
NPI:1609150317
Name:TUCKER, ROBERT NEAL
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:NEAL
Last Name:TUCKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 W ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-4799
Mailing Address - Country:US
Mailing Address - Phone:847-358-5510
Mailing Address - Fax:
Practice Address - Street 1:1760 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-4799
Practice Address - Country:US
Practice Address - Phone:847-358-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor