| Jacque Ruch Lcsw, Ltd. | |
|
650 N Main St Rockford IL 61103-6921 | |
| (815) 243-8332 | |
| (847) 693-3099 |
| Full Name | Jacque Ruch Lcsw, Ltd. |
|---|---|
| Speciality | Psychologist - Group Psychotherapy |
| Location | 650 N Main St, Rockford, Illinois |
| Authorized Official Name and Position | Missy L Wilson (OFFICE MANAGER) |
| Authorized Official Contact | 8156211932 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacque Ruch Lcsw, Ltd. 650 N Main St Rockford IL 61103-6921 Ph: (815) 243-8332 | Jacque Ruch Lcsw, Ltd. 650 N Main St Rockford IL 61103-6921 Ph: (815) 243-8332 |
| NPI Number | 1265970180 |
|---|---|
| Provider Enumeration Date | 02/11/2017 |
| Last Update Date | 02/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265970180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP2701X | Psychologist - Group Psychotherapy | 149015073 (Illinois) | Primary |
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