Individual
CHARLES R POLCASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
7804 W COLLEGE DR, 2NE, PALOS HEIGHTS, IL 60463-1025
(708) 448-0884
(708) 448-0594
Mailing address
12804 S SENECA RD, PALOS HEIGHTS, IL 60463-2169
(708) 448-0884
(708) 448-0594
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180000331
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632157
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/09/2006
Last updated
03/11/2014
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