Provider Demographics
NPI:1912996109
Name:CUCCO, CARL D (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:D
Last Name:CUCCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1300 E. WOODFIELD RD STE 308
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173
Mailing Address - Country:US
Mailing Address - Phone:847-485-2650
Mailing Address - Fax:847-221-4651
Practice Address - Street 1:1300 E. WOODFIELD RD STE 308
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173
Practice Address - Country:US
Practice Address - Phone:847-485-2650
Practice Address - Fax:847-221-4651
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-059369207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP09295Medicare PIN
ILC43194Medicare UPIN