MEDICARE: PAIGE BARTUCH MSN, APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209029216	IL

General Provider Information

NPI Number	:	1528822533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE BARTUCH MSN, APRN, FNP-C

Provider Business Mailing Address
First Line	:	4219 BELSON LN
Second Line	:
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60014-6589
Country	:	US
Telephone Number	:	847-845-1261
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 W ERIE ST STE 110
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-5700
Country	:	US
Telephone Number	:	847-845-1261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2024
Last Update Date	:	01/14/2026

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