Individual provider Active NPI

Samantha L Bertucci, DO

  • Occupational Therapist
  • Glenview, IL
National Provider Identifier
1043102460
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056016635 Issued in IL
Practice address
2401 Ravine Way Ste 100
Glenview, IL 60025-7645
Phone
(847) 724-4791
Fax
(847) 998-6916
NPI assigned
Jul 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056016635 IL Primary

Addresses

Primary practice location

2401 Ravine Way Ste 100
Glenview, IL 60025-7645

Mailing address

273 Michigan Ave
Highwood, IL 60040-1808
Phone (224) 324-1178

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250912002789 IL Practitioner - Occupational Therapist in Private Practice 0345743555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Bone and Joint Institute, LLCGroup PAC ID 6002814878, 603 clinicians

Practice addresses (Care Compare)

2401 Ravine Way
Suite 100
Glenview, IL 60025-7645
Phone (847) 724-4791

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute, LLC CurrentSince Jul 28, 2025 Accepting new patients
Illinois Bone and Joint Institute LLC CurrentSince Jul 28, 2025 Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

2401 Ravine Way
Ste 100
Glenview, IL 60025
Phone (847) 724-4791

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1752796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1043102460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 MICHIGAN AVE",
            "city": "HIGHWOOD",
            "state": "IL",
            "postal_code": "600401808",
            "telephone_number": "224-324-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 RAVINE WAY STE 100",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257645",
            "telephone_number": "847-724-4791",
            "fax_number": "847-998-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTUCCI",
        "first_name": "SAMANTHA",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-18",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056016635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.