Individual
MR. ROBERT KOUPAL
Active
Individual
MR. ROBERT KOUPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00529
IA
1041C0700X
Clinical Social Worker
149006072
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0582221
—
IL
01
—
149006072
BLUE CROSS ILLINOIS NUMBE
IL
05
—
1582221
—
IL
01
—
2216745
FIRST HEALTH AND CCN NUMB
IL
01
—
34752
BLUE CROSS IOWA IA NUMBER
IA
01
—
99862
BLUE CROSS IOWA IL NUMBER
IL
01
—
IL0199
JOHN DEERE NUMBER
IL
Enumeration date
08/26/2005
Last updated
04/22/2013
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