PAUL H BONUCCI (NPI# 1922114677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922114677 |
| Entity Type | Individual |
| Full Name | PAUL H BONUCCI |
| Credential | MD |
| Practice Address |
2128 N Main St Princeton IL 61356-9728 |
| Mailing Address |
1124 Prairie Ln S Princeton IL 61356-2383 |
| Practice Telephone | 8158752273 |
| Practice Fax Number | 8152078682 |
| Mailing Telephone | 8159156435 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2020-10-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 036100221 | IL | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 31178 | SC | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 048980 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | G48980 | 05 | |
| IL | 036100221 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1124 Prairie Ln S, Princeton, IL 613562383 | 8159156435 | |
| 530 Park Ave E, Princeton, IL 61356 | 8158752811 |
| Street Address |
2128 N MAIN ST |
| City | PRINCETON |
| State | IL |
| Zip Code | 61356-9728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366077695 | Rebekka Root | Nurse Practitioner | 2128 N Main St, Princeton, IL 61356-9728 | 2020-03-06 |
| 1770002677 | Cory J Kramer | Nurse Practitioner | 2128 N Main St, Princeton, IL 61356 | 2017-09-12 |
| 1699229823 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 2128 N Main St, Princeton, IL 61356-9728 | 2016-08-04 |
| 1326408204 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 2128 N Main St, Princeton, IL 61356-9728 | 2016-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548698558 | Shelley Gorenz | Counselor | 1009 S. Main St., Princeton, IL 61356 | 2013-10-30 |
| 1780016626 | Jennifer Phillips | Pharmacist | 610 N. Main St., Princeton, IL 61356 | 2013-08-02 |
| 1477848521 | Princeton Prompt Care LLC | Clinic/Center | 2128 North Main Street, Princeton, IL 61356 | 2011-06-16 |
| 1306014196 | Lifefit Physical Rehab, Ltd. | Clinic/Center | 1225 N. Sixth St., Princeton, IL 61356 | 2008-02-14 |
| 1568669778 | Hawthorne Inn Supportive Living Facility | Assisted Living Facility | 136 N. Sixth St., Princeton, IL 61356 | 2007-06-29 |
| 1720209240 | Michelle Lee Mortensen | Music Therapist | 816 S. First St., Princeton, IL 61356 | 2007-05-01 |
| 1073733465 | Jarred Allen Farrell | Chiropractor | 682 East Peru Street, Princeton, IL 61356 | 2007-04-26 |
| 1952488397 | Donald R Marion | Optometrist | 2 Park Avenue West, Princeton, IL 61356 | 2006-11-01 |
| 1427138247 | Bruce Waldo Shriver | Dentist | 422 E Peru St, Princeton, IL 61356 | 2006-10-16 |
| 1871689612 | Jason A Monroe | Dentist | 334 Backbone Rd East, Princeton, IL 61356 | 2006-10-05 |
| Find all providers in zip 61356 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790170835 | Chad Williams | Emergency Medicine | 177 Highpoint Ln, Princeton, WV 24739-6454 | 2015-04-06 |
| 1326351461 | Medexpress Urgent Care, Inc - West Virginia | Emergency Medicine | 277 Greasy Ridge Road, Princeton, WV 24740-6900 | 2010-07-19 |
| 1447372867 | Mark Alexander Spitzer | Emergency Medicine | 2767 Clover Dew Dairy Rd, Princeton, WV 24740-7548 | 2007-04-05 |
| 1578698163 | Charles John Mchugh | Emergency Medicine | 4 Charlton St, Princeton, NJ 08540-5232 | 2007-02-22 |
| 1366503088 | Dennis P Price | Emergency Medicine | 59 Coppervail Ct, Princeton, NJ 08540-7714 | 2006-12-13 |
| 1316971807 | J. Eric Dario Castro | Emergency Medicine | 530 Park Ave East, Dept of Emergency Medicine, Princeton, IL 61356 | 2006-07-10 |
| 1952333494 | Nara C Shin | Emergency Medicine | Washington Road, Princeton, NJ 08544-5002 | 2006-07-07 |
| 1750327342 | James P Morgan | Emergency Medicine | 277 Greasy Ridge Rd, Princeton, WV 24739-6900 | 2006-06-21 |
| 1306887674 | Gregg E Davis | Emergency Medicine | 204 Park Ave E, Princeton, IL 61356-2114 | 2006-06-09 |
| 1386683456 | Thomas Gerard Rousseau | Emergency Medicine | 914 Turnbury Dr, Princeton, KY 42445-2802 | 2006-06-05 |
| Find all providers in PRINCETON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.