Individual
DR. ROBERT JOSEPH BOUCEK JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
2506 GALEN DR, #103, CHAMPAIGN, IL 61821-7046
(217) 398-0744
(217) 398-0778
Mailing address
2506 GALEN DRIVE, #103, CHAMPAIGN, IL 61821-7047
(217) 398-0744
(217) 398-0778
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008794
IL
103TC0700X
Clinical Psychologist
PSY23495
CA
Other
Enumeration date
06/22/2010
Last updated
05/01/2015
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