=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245181684
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BERTRAND CHUATICO NP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/03/2026
-----------------------------------------------------
Last Update Date | 02/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1340 REMINGTON RD STE P
-----------------------------------------------------
City | SCHAUMBURG
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60173-4821
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-873-8693
-----------------------------------------------------
Fax | 847-873-8486
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10458 SCOTT DR
-----------------------------------------------------
City | HUNTLEY
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60142-2379
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 847-873-8693
-----------------------------------------------------
Fax | 847-873-8486
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 2025073757
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 2025073757
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------