Individual
DR. MARLA J VANNUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2835 N SHEFFIELD AVE STE 410, CHICAGO, IL 60657-5084
(312) 281-2901
Mailing address
5551 HIGH TOR HL, COLUMBIA, MD 21045-2465
(773) 412-0872
(312) 281-2901
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071006033
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1633497
BCBS PROVIDER NUMBER
IL
Enumeration date
06/15/2006
Last updated
02/12/2026
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