MR. MICHAEL C TUCKER (NPI# 1962524793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962524793 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL C TUCKER |
| Credential | MS CADC |
| Practice Address |
748 Timbercreek Road Dixon IL 61021 |
| Practice Telephone | 8152843940 |
| Practice Fax Number | 8152849267 |
| Mailing Telephone | 8152843940 |
| Mailing Fax Number | 8152849267 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
A10440001A | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417332321 | Michael Tucker | Physician Assistant | 5171 N Santa Monica Blvd, Apt 4, Milwaukee, WI 53217-5538 | 2015-07-22 |
| 1699073783 | Michael David Tucker | Counselor | 309 W 12th St., Vancouver, WA 98660-1209 | 2011-03-14 |
| 1962554535 | Michael Randolph Tucker | Dentist | 502 Prairie, Winnsboro, LA 71295 | 2007-01-17 |
| 1477661882 | Michael C Tucker | Chiropractor | 7721 Dollarway Rd, Suite 1, White Hall, AR 71602 | 2006-08-26 |
| 1972148930 | Michael Tucker | Case Manager/Care Coordinator | 2000 Aldersgate Rd, Little Rock, AR 72205-7018 | 2019-11-14 |
| 1306489463 | Michael Tucker | Anesthesiologist Assistant | 1000 Johnson Ferry Rd, Atlanta, GA 30342-1606 | 2019-10-22 |
| 1881247328 | Michael Tucker | Dentist | 222 N Chelan Ave, Wenatchee, WA 98801-2105 | 2019-07-23 |
| 1902210107 | Michael A Tucker | Optometrist | 1155 Pocatello Creek Rd, Pocatello, ID 83201-2949 | 2014-06-16 |
| 1831471457 | Michael A Tucker | Pharmacist | 7338 Dixie Hwy, Louisville, KY 40258-3722 | 2011-09-10 |
| 1073703187 | Michael James Tucker | Orthopaedic Surgery | 900 Cooper Ave, Suite 3100, Saginaw, MI 48602-5182 | 2007-07-26 |
| Street Address |
748 TIMBERCREEK ROAD |
| City | DIXON |
| State | IL |
| Zip Code | 61021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205017373 | Adult Education Associates | Registered Nurse | 748 Timbercreek Road, Dixon, IL 61021 | 2007-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699331082 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1600 South Galena Ave, Dixon, IL 61021 | 2019-05-12 |
| 1285135590 | Richard Allen Sibert | Counselor | 325 Il Route 2,dixon Il, Dixon, IL 61021 | 2018-02-22 |
| 1518485432 | Madeline Luniewicz | Counselor | 325 Il-2, Dixon, IL 61021 | 2017-08-30 |
| 1669992566 | Nicole Marie Shaffer | Specialist/Technologist | 650 Reynoldswood Road, Dixon, IL 61021 | 2017-06-21 |
| 1346660446 | Lydia Sitter | Audiologist | 215 3. 1st Street, Suite 317, Ksb Medical Group, Dixon, IL 61021 | 2014-04-16 |
| 1053600080 | Janet I. Malmberg | Nurse Practitioner | 309 South Galena Ave, Suite 100, Dixon, IL 61021 | 2011-03-30 |
| 1376775262 | Kelly L Klein | Optometrist | 511 Palmyra Street, Ksb Eye & Vision Care, Dixon, IL 61021 | 2009-08-11 |
| 1013119106 | Michael Joseph Sarno | Physical Therapist | 401 E. First Street, Dixon, IL 61021 | 2007-06-01 |
| 1891905600 | Thomas G. Gehlbach | Internal Medicine | 215 E 1st St Ste 111, Dixon, IL 61021 | 2007-05-23 |
| 1699987230 | Sameer Jain | Family Medicine | 102 S. Hennepin Ave., Ksb Medical Group, Dixon, IL 61021 | 2007-05-04 |
| Find all providers in zip 61021 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902451669 | Angel Ann-marie Gatchel | Counselor | 715 Berkshire Ct, Dixon, CA 95620-2223 | 2019-08-08 |
| 1568021137 | Kim Miller | Counselor | 748 Timber Creek Rd, Dixon, IL 61021-9564 | 2019-06-07 |
| 1285135590 | Richard Allen Sibert | Counselor | 325 Il Route 2,dixon Il, Dixon, IL 61021 | 2018-02-22 |
| 1821390972 | Stephanie Knight Englund | Counselor | 325 Rte 2, Dixon, IL 61021-9118 | 2010-11-23 |
| 1427117118 | Kelly L Burrow | Counselor | 325 Il Rt 2, Dixon, IL 61021 | 2006-12-08 |
| 1275133514 | Stephanie Mae Roman | Counselor | 325 Illinois Rt 2, Dixon, IL 61021-9118 | 2020-10-27 |
| 1659913929 | Emma Swanson | Counselor | 922 Washington Ave, Dixon, IL 61021-1254 | 2019-10-08 |
| 1417517277 | Alison Danielle White | Counselor | 325 Illinois Rt 2, Dixon, IL 61021-9118 | 2019-06-14 |
| 1295213882 | Jessica M Douglass | Counselor | 325 Il Route 2, Dixon, IL 61021-9118 | 2018-08-06 |
| 1578063129 | Jeff Aaron Woods | Counselor | 325 Il Route 2, Dixon, IL 61021-9118 | 2018-02-20 |
| Find all providers in DIXON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.