Provider Demographics
NPI:1598453466
Name:BELLUCCI, KATHERINE (RN)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:BELLUCCI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:BOYK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3001 GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60064-3048
Mailing Address - Country:US
Mailing Address - Phone:224-610-7003
Mailing Address - Fax:224-610-7005
Practice Address - Street 1:3001 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064-3048
Practice Address - Country:US
Practice Address - Phone:224-610-7003
Practice Address - Fax:224-610-7005
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041298903163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator