Individual
KYLE W BOERKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
7317 N WILLOW LAKE CT, PEORIA, IL 61614-8227
(309) 683-7373
(309) 691-4408
Mailing address
7317 N WILLOW LAKE CT, PEORIA, IL 61614-8227
(309) 683-7373
(309) 691-4408
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071007906
IL
Other
Enumeration date
07/12/2010
Last updated
07/12/2010
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