Provider Demographics
NPI:1932224441
Name:CUTTICA, MICHAEL J (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:CUTTICA
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 1:676 N SAINT CLAIR ST STE 2100
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2993
Mailing Address - Country:US
Mailing Address - Phone:312-695-1800
Mailing Address - Fax:312-695-4741
Practice Address - Street 1:676 N SAINT CLAIR ST STE 2100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2993
Practice Address - Country:US
Practice Address - Phone:312-695-1800
Practice Address - Fax:312-695-4741
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0065531207RC0200X
IL036111053207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC038744200Medicaid
MD89825201OtherCAREFIRST BCBS
MD412360300Medicaid
MD415096100Medicaid
DC19460035OtherCAREFIRST BCBS
DC038744200Medicaid
DC021596I28Medicare PIN