Individual
CARL A. BUCCELLATO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 N MILWAUKEE AVE, VERNON HILLS, IL 60061-4304
(847) 941-7900
(847) 941-7902
Mailing address
2650 RIDGE AVE, EVANSTON HOSPITAL, EVANSTON, IL 60201-1718
(847) 570-1206
(847) 570-1248
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036095967
IL
Other
Enumeration date
08/15/2006
Last updated
02/10/2021
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