Healthcare Provider Details

I. General information

NPI: 1598721250
Provider Name (Legal Business Name): JAMES MICHAEL TUCHEK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 05/14/2021
Certification Date: 05/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 W 203RD ST STE 203
OLYMPIA FIELDS IL
60461-1190
US

IV. Provider business mailing address

2650 WARRENVILLE RD STE 280
DOWNERS GROVE IL
60515
US

V. Phone/Fax

Practice location:
  • Phone: 708-679-2010
  • Fax:
Mailing address:
  • Phone: 630-324-7911
  • Fax: 630-324-7942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number2001927
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number036081136
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: