NPI Code Details Logo

NPI 1962867812

NPI 1962867812 : ROBERT CHUCKA PSYD LLC : MILWAUKEE, WI

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1962867812
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    ROBERT CHUCKA PSYD LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/18/2015
-----------------------------------------------------
    Last Update Date     |    01/09/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    3364 S 11TH ST 
-----------------------------------------------------
    City                 |    MILWAUKEE
-----------------------------------------------------
    State                |    WI
-----------------------------------------------------
    Zip                  |    53215-5133
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    414-285-6456
-----------------------------------------------------
    Fax                  |    414-285-6456
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    3364 S 11TH ST 
-----------------------------------------------------
    City                 |    MILWAUKEE
-----------------------------------------------------
    State                |    WI
-----------------------------------------------------
    Zip                  |    53215-5133
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    414-285-6456
-----------------------------------------------------
    Fax                  |    414-285-6456
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    PSYCHOLOGIST/SOLE PROPRIETOR
-----------------------------------------------------
    Name                 |    DR. ROBERT A CHUCKA 
-----------------------------------------------------
    Credential           |    PSYD
-----------------------------------------------------
    Telephone            |    414-285-6456
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    103T00000X
-----------------------------------------------------
    Taxonomy Name        |    Psychologist
-----------------------------------------------------
    License Number       |    2469-57
-----------------------------------------------------
    License Number State |    WI
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.