Healthcare Provider Details

I. General information

NPI: 1568959526
Provider Name (Legal Business Name): JOSHUA SANTUCCI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2018
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 CENTRAL ST. SUITE 880
EVANSTON IL
60201-1780
US

IV. Provider business mailing address

CLEVELAND CLINIC 9500 EUCLID AVENUE
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2570
  • Fax: 847-733-5785
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number25MA11868700
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number25MA11868700
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number036176002
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: