Healthcare Provider Details

I. General information

NPI: 1508923913
Provider Name (Legal Business Name): JOHN C. RAUCCI N.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 W CENTRAL RD SUITE 5100
ARLINGTON HEIGHTS IL
60005-2355
US

IV. Provider business mailing address

5241 CLEVELAND ST
SKOKIE IL
60077-2413
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-2080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: