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NPI Code Detail

MEDICARE: ANTHONY TUCCI PHD LLC

MEDICARE: ANTHONY TUCCI PHD LLC
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
1103TC0700XClinical Psychologist

General Provider Information

NPI Number : 1285282889
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANTHONY TUCCI PHD LLC
Provider Business Mailing Address
First Line : 605 E VAN BUREN ST
Second Line :
City : VILLA PARK
State : IL
Zip : 60181-3321
Country : US
Telephone Number : 630-280-8173
Fax Number : 630-560-6412
Provider Business Practice Location Address
First Line : 2021 MIDWEST RD STE 104
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1396
Country : US
Telephone Number : 630-479-8648
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ANTHONY MICHAEL TUCCI
Credential : PHD
Telephone Number : 630-280-8173
Provider Enumeration Date : 08/28/2019
Last Update Date : 03/24/2026

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