Individual
MR. ROBERT KOUPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2102 E 38TH ST, DAVENPORT, IA 52807-1135
(563) 359-4049
(563) 359-4069
Mailing address
2102 E 38TH ST, DAVENPORT, IA 52807-1135
(563) 359-4049
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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