Provider Demographics
NPI:1679669881
Name:WECKLER, ROBERT WALLACE (CSADC, NCAC II)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:WALLACE
Last Name:WECKLER
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Gender:M
Credentials:CSADC, NCAC II
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Mailing Address - Street 1:68 AMBROGIO DR
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-3339
Mailing Address - Country:US
Mailing Address - Phone:847-662-5588
Mailing Address - Fax:847-662-5875
Practice Address - Street 1:68 AMBROGIO DR
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3339
Practice Address - Country:US
Practice Address - Phone:847-662-5588
Practice Address - Fax:847-662-5875
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)