Provider Demographics
NPI:1932213469
Name:BARTUCCI, EUGENE J (MD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:J
Last Name:BARTUCCI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 WEST BUTTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5017
Mailing Address - Country:US
Mailing Address - Phone:630-834-0491
Mailing Address - Fax:630-834-0735
Practice Address - Street 1:300 WEST BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5017
Practice Address - Country:US
Practice Address - Phone:630-834-0491
Practice Address - Fax:630-834-0735
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036063043207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036063043Medicaid
IL431660Medicare ID - Type UnspecifiedGROUP NUMBER
ILD16015Medicare UPIN