MEDICARE: WOMANCARE, P.C.

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
1	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1487650982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOMANCARE, P.C.

Provider Business Mailing Address
First Line	:	221 W PROSPECT AVE
Second Line	:
City	:	MT PROSPECT
State	:	IL
Zip	:	60056-3136
Country	:	US
Telephone Number	:	847-221-4800
Fax Number	:	847-221-4896

Provider Business Practice Location Address
First Line	:	221 W PROSPECT AVE
Second Line	:
City	:	MT PROSPECT
State	:	IL
Zip	:	60056-3136
Country	:	US
Telephone Number	:	847-221-4800
Fax Number	:	847-221-4896

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DR. CARL DAVID CUCCO
Credential	:	M.D.
Telephone Number	:	847-221-4800

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	11/05/2007

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Directions to “WOMANCARE, P.C. ” Practice Location

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