Charles J Marcuccilli MD

NPI 1801849559 - Psychiatry & Neurology - 2084N0400X

NPI Details
NPI 1801849559
Gender Male
Enumeration Date 05/17/2006
Last Updated 11/08/2013
Entity Type Individual
Active Over 10 years ago
Practice Location
180 HARVESTER DR
SUITE 110
BURR RIDGE IL, 60527-7594, US
Phone (773) 702-1150
Fax
Business Location
5841 S MARYLAND AVE
DEPT OF PEDIATRICS, MC 3055
CHICAGO IL, 60637-1447, US
Phone (773) 702-6487
Fax
Toxanomy
Taxonomy Code 2084N0400X
License State Wisconsin
License Number 48736
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According to our database, Dr. Charles J Marcuccilli MD NPI is 1801849559, taxonomy code is 2084N0400X and license number is 48736, license state is located at Wisconsin. Charles J Marcuccilli MD physically located at 180 Harvester Dr, Burr Ridge IL, 60527-7594. NPI Number Charles J Marcuccilli MD has the Individual type.

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1801849559 NPI number is provided on an as is basis without warranty of any kind. 1801849559 is maintained by the National Plan & Provider Enumeration System. The contents of Charles J Marcuccilli MD are for informational purposes only.