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Organization
NORTHERN LAKE MEDICAL, LTD.
Active
Organization
NORTHERN LAKE MEDICAL, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK TUCCI M.D. (PRESIDENT)
(847) 587-0115
Entity
Organization
Contact information
Practice address
45 TOWER CT, SUITE C, GURNEE, IL 60031-3376
(847) 623-3200
(847) 623-9168
Mailing address
45 TOWER CT, SUITE C, GURNEE, IL 60031-3376
(847) 623-3200
(847) 623-9168
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/27/2006
Last updated
08/22/2020
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