Provider Demographics
NPI:1538642822
Name:BUCHKOE, ERIC STEVEN (MA, PSYD, LP)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:STEVEN
Last Name:BUCHKOE
Suffix:
Gender:M
Credentials:MA, PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 E SUPERIOR ST STE 306
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2595
Mailing Address - Country:US
Mailing Address - Phone:312-754-9404
Mailing Address - Fax:312-754-9402
Practice Address - Street 1:1 E SUPERIOR ST STE 306
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2595
Practice Address - Country:US
Practice Address - Phone:312-754-9404
Practice Address - Fax:312-754-9402
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.011485103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical