Carl Anthony Buccellato (NPI# 1265545446, PAC ID# 1153327424) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OBSTETRICS/GYNECOLOGY.
| Nation Provider ID (NPI) | 1265545446 |
| PAC ID by PECOS | 1153327424 |
| Professional Enrollment ID | I20061010000101 |
| Full Name | Carl Anthony Buccellato |
| Organization Legal Name | NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES |
| Address |
15 Tower Ct Suite 300 Gurnee IL 60031-3346 |
| Phone Number | 8475998899 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF MICHIGAN MEDICAL SCHOOL |
| Graduation Year | 1995 |
| Primary Specialty | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 2163334699 |
| Number of Group Practice Members | 1274 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140010 | NORTHSHORE UNIVERSITY HEALTHSYSTEM - EVANSTON HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2650 Ridge Ave, Evanston, IL 60201-1718 | NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES | |
| 15 Tower Ct, Suite 300, Gurnee, IL 60031-3346 | 8475998899 | NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES |
| 777 Park Ave W, Highalnd Park, IL 60035-2433 | NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES | |
| 777 Park W Ave, Highland Park, IL 60035-2433 | 8474328000 | NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES |
| 1329 N Wolf Rd, Mount Prospect, IL 60056-1500 | 8478033040 | NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES |
| 1329 N Wolf Rd Unit, 2a, Mount Prospect, IL 60056-1500 | 8478033040 | NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES |
| 225 N Milwaukee Ave, Vernon Hills, IL 60061-4304 | 8479417600 | NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES |
| Organization Legal Name | NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES |
| Physicians | 1409 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Gina R Shokry | Internal Medicine | Northshore University Healthsystem Faculty Practice Associates | 71 Waukegan Rd, Suite 700, Lake Bluff, IL 60044-1614 |
| Amy E Westlake Milroy | Nurse Practitioner | Northshore University Healthsystem Faculty Practice Associates | 920 Milwaukee Ave, Lincolnshire, IL 60069-3839 |
| Eamann Ayyad | Nurse Practitioner | Northshore University Healthsystem Faculty Practice Associates | 9977 Woods Dr 2nd Floor, Skokie, IL 60077-1057 |
| Jennifer M. Magnuson | Nurse Practitioner | Northshore University Healthsystem Faculty Practice Associates | 9977 Woods Dr, Skokie, IL 60077-1057 |
| George Sousanieh | Nephrology | Northshore University Healthsystem Faculty Practice Associates | 777 Park W Ave, Highland Park, IL 60035-2433 |
| Kathleen M Colella | Nurse Practitioner | Northshore University Healthsystem Faculty Practice Associates | 2180 Pfingsten Rd, Suite 3000, Glenview, IL 60026-1340 |
| Michelle Elizabeth John | Psychiatry | Northshore University Healthsystem Faculty Practice Associates | 49 S Waukegan Rd, Suite 200, Deerfield, IL 60015-5204 |
| Rebecca Wanting Tsang | Gastroenterology | Northshore University Healthsystem Faculty Practice Associates | 2150 Pfingsten Rd, Suite 3000, Glenview, IL 60026-1314 |
| Jonathan H Seyfert | Family Medicine | Northshore University Healthsystem Faculty Practice Associates | 1329 N Wolf Rd, Mount Prospect, IL 60056-1500 |
| Emily K Andrew | Internal Medicine | Northshore University Healthsystem Faculty Practice Associates | 1007 Church St, Suite 100, Evanston, IL 60201-5910 |
| Street Address |
15 TOWER CT SUITE 300 |
| City | GURNEE |
| State | IL |
| Zip | 60031-3346 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Matthew S Plofsky | Family Medicine | Northshore University Healthsystem Faculty Practice Associates | 15 Tower Ct, Suite 300, Gurnee, IL 60031-3346 |
| Asif Anwar | Internal Medicine | Waukegan Clinic Corp | 15 Tower Ct, Suite 265, Gurnee, IL 60031-3340 |
| Rebecca G Houglum | Physician Assistant | Northshore University Healthsystem Faculty Practice Associates | 15 Tower Ct, Suite 300, Gurnee, IL 60031-3346 |
| Mark Gerald Neerhof | Obstetrics/gynecology | Northshore University Healthsystem Faculty Practice Associates | 15 Tower Ct, Suite 300, Gurnee, IL 60031-3346 |
| Adam Gafni Kane | Obstetrics/gynecology | Northshore University Healthsystem Faculty Practice Associates | 15 Tower Ct, Suite 300, Gurnee, IL 60031-3346 |
| Maryfaith C Terkildsen | Obstetrics/gynecology | Northshore University Healthsystem Faculty Practice Associates | 15 Tower Ct, Suite 300, Gurnee, IL 60031-3346 |
| David D. Soo | Family Medicine | Northshore University Healthsystem Faculty Practice Associates | 15 Tower Ct, Suite 300, Gurnee, IL 60031-3346 |
| Kunal Patel | Internal Medicine | Waukegan Clinic Corp | 15 Tower Ct, Suite 265, Gurnee, IL 60031-3340 |
| Jeffrey J Hicks | Podiatry | 15 Tower Ct, Suite 250, Gurnee, IL 60031-3336 | |
| Nicholas Nikitas | Family Medicine | Northshore University Healthsystem Faculty Practice Associates | 15 Tower Ct, Suite 300, Gurnee, IL 60031-3346 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda J Caplan | Family Medicine | Northshore University Healthsystem Faculty Practice Associates | 7900 Rollins Rd, Gurnee, IL 60031-1512 |
| Rebecca E Jacobson | Obstetrics/gynecology | Northshore University Healthsystem Faculty Practice Associates | 7900 Rollins Rd, Gurnee, IL 60031-1512 |
| Lauren E Rosen | Nurse Practitioner | Northshore University Healthsystem Faculty Practice Associates | 7900 Rollins Rd, Gurnee, IL 60031-1512 |
| Esther Y Liu | Family Medicine | Northshore University Healthsystem Faculty Practice Associates | 7900 Rollins Rd, Gurnee, IL 60031-1512 |
| Erik B Pauls | Physician Assistant | Northshore University Healthsystem Faculty Practice Associates | 7900 Rollins Rd, Gurnee, IL 60031-1512 |
| Smitha K. John | Nurse Practitioner | Northshore University Healthsystem Faculty Practice Associates | 7900 Rollins Rd, Gurnee, IL 60031-1512 |
| Brenda Y Kim | Obstetrics/gynecology | Northshore University Healthsystem Faculty Practice Associates | 7900 Rollins Rd, Gurnee, IL 60031-1512 |
| Rajiv K Udani | Hospitalist | Northshore University Healthsystem Faculty Practice Associates | 7900 Rollins Rd, Gurnee, IL 60031-1512 |
| Nancy A Nora | Nephrology | Northshore University Healthsystem Faculty Practice Associates | 7900 Rollins Rd, Gurnee, IL 60031-1512 |
| Therese A Hughes | Obstetrics/gynecology | Northshore University Healthsystem Faculty Practice Associates | 7900 Rollins Rd, Gurnee, IL 60031-1512 |
| Find all physicians in zip 60031 | |||
| City | GURNEE |
| Zip Code | 60031 |
| Specialty | OBSTETRICS/GYNECOLOGY |
| City + Specialty | GURNEE + OBSTETRICS/GYNECOLOGY |
Please comment or provide details below to improve the information on Carl Anthony Buccellato.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.