Donald M Buckman, PH D
Individual provider Active NPI Clinical Child & Adolescent Psychologist · Eldorado, IL
NPI 1497982847 · NPPES record last updated May 18, 2021
Key facts
- NPI
- 1497982847
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Child & Adolescent Psychologist 103TC2200X
- License
- 071009325 (IL)
- Practice address
- 1910 4TH St
Eldorado, IL 62930-1741 - Phone
- (224) 325-5436
- Fax
- (618) 273-2808
- NPI assigned
- Jun 12, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071009325 | IL | MD | Clinical Child & Adolescent Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stress & Trauma Treatment Center, Inc. | Current |
Accepting new patients | |
| Stress & Trauma Treatment Center | Clinical Child & Adolescent | Current | Accepting new patients |
Locations
1200 Locust St
Eldorado, IL 62930
Phone (618) 252-9036
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 071009325 | IL | Yes |
Addresses
Primary practice location
1910 4TH St
Eldorado, IL 62930-1741
Mailing address
1910 4TH St
Eldorado, IL 62930-1741
Phone (224) 325-5436
Other providers in Eldorado, IL
- Jason K Brannock
- April M Brown
- Danielle Rose Brown
- Tiera Corrina Brown
- Brigitte D Browning
- Kasey Buckman
- Brad Burklow
- Janice Dianne Burrus
- C V Kasiar LTD
- Rae H Cain
All providers in Eldorado, IL · Clinical Child & Adolescent Psychologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.