Individual
MR. MICHAEL C TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS CADC
Contact information
Practice address
748 TIMBERCREEK ROAD, DIXON, IL 61021
(815) 284-3940
(815) 284-9267
Mailing address
748 TIMBERCREEK ROAD, DIXON, IL 61021
(815) 284-3940
(815) 284-9267
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
A10440001A
IL
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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