Individual
PAUL H BONUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2128 N MAIN ST, PRINCETON, IL 61356-9728
(815) 875-2273
(815) 207-8682
Mailing address
1124 PRAIRIE LN S, PRINCETON, IL 61356-2383
(815) 915-6435
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
036100221
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100221
—
IL
05
—
G48980
—
SC
Enumeration date
08/22/2006
Last updated
06/09/2025
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