MR. MICHAEL C TUCKER MS CADC
NPI 1962524793
Counselor - Addiction (Substance Use Disorder) in Dixon, IL
Active since April 04, 2007
About Mr. Michael C Tucker Ms Cadc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. MICHAEL C TUCKER MS CADC (NPI 1962524793) is an individual addiction (substance use disorder) provider in Dixon, Illinois, licensed in Illinois (A10440001A) and active in the NPI registry since April 2007.
NPPES Registry Identity
NPI1962524793
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. MICHAEL C TUCKERCredential: MS CADC
Location Address748 TIMBERCREEK ROADDixon, IL 61021
Mailing Address748 Timbercreek RoadDixon, IL 61021 · (815) 284-3940 · Fax (815) 284-9267
Phone(815) 284-3940
Fax(815) 284-9267
Sole ProprietorNo
Enumeration DateApril 4, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1962524793 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in IL · A10440001A
748 TIMBERCREEK ROAD, Dixon, IL 61021
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1962524793, enumerated as an "individual" on April 04, 2007.
The provider is located at 748 TIMBERCREEK ROAD DIXON, IL 61021 and the phone number is (815) 284-3940.
Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).
