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NPI Code Detail

MEDICARE: MICHAEL ROBERT MARCUCCI M.A., CCC-SLP

MEDICARE: MICHAEL ROBERT MARCUCCI M.A., CCC-SLP
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
1235Z00000XSpeech-Language Pathologist146.016542IL

General Provider Information

NPI Number : 1518655018
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ROBERT MARCUCCI M.A., CCC-SLP
Provider Business Mailing Address
First Line : 1911 ROHLWING RD STE A
Second Line :
City : ROLLING MEADOWS
State : IL
Zip : 60008-1397
Country : US
Telephone Number : 224-248-9449
Fax Number :
Provider Business Practice Location Address
First Line : 1911 ROHLWING RD STE A
Second Line :
City : ROLLING MEADOWS
State : IL
Zip : 60008-1397
Country : US
Telephone Number : 224-248-9449
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2023
Last Update Date : 04/24/2023

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Directions to “ MICHAEL ROBERT MARCUCCI M.A., CCC-SLP” Practice Location

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