Individual provider Active NPI

Mark Tucci, M.D.

  • Internal Medicine Physician
  • Gurnee, IL
National Provider Identifier
1831186568
Registry record updated Oct 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36-065644 Issued in IL
Practice address
7505 Grand Ave
Gurnee, IL 60031-1551
Phone
(847) 245-8448
NPI assigned
Sep 27, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36-065644 IL Primary

Addresses

Primary practice location

7505 Grand Ave
Gurnee, IL 60031-1551

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

81 E Grand Ave
Fox Lake, IL 60020-1557
Phone (847) 587-0115

Other identifiers 1

IdentifierTypeStateIssuer
100005757MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mtucci42428@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20031120000099 IL Practitioner - Internal Medicine 4880508175 Reassigns benefits to 1 organization
I20100129000459 WI Practitioner - Internal Medicine 4880508175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amg Illinois LTDGroup PAC ID 8527117027, 24 clinicians

Practice addresses (Care Compare)

10400 75TH St
Kenosha, WI 53142-7884
Phone (262) 948-7000

45 Tower CT
Gurnee, IL 60031-3376
Phone (847) 623-3200

7505 Grand Ave
Gurnee, IL 60031-1551
Phone (847) 245-8448

Hospital & facility affiliations

  • Advocate Home Health Care Serv Home health agency, Oakbrook, IL, CCN 147150
  • Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202
  • Aurora Medical Center Kenosha Hospital, Kenosha, WI, CCN 520189
  • Advocate Good Shepherd Hospital Hospital, Barrington, IL, CCN 140291

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36-065644ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Amg Illinois LTD CurrentSince Apr 1, 2009 Accepting new patients
Amg Illinois LTD Internal Medicine CurrentSince Apr 1, 2009 Accepting new patients

Locations

81 E Grand Ave
Fox Lake, IL 60020
Phone (224) 908-3005

45 Tower Ct
Gurnee, IL 60031
Phone (847) 623-3200

45 Tower Ct
#C
Gurnee, IL 60031
Phone (847) 623-3200

7505 Grand Ave
Gurnee, IL 60031
Phone (847) 245-8448

10400 75th St
Kenosha, WI 53142
Phone (262) 697-7000

Interoperability endpoints

  • Direct secure messaging: mtucci42428@direct.myadvocateaurora.org

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728864000000",
    "number": "1831186568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7505 GRAND AVE",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600311551",
            "telephone_number": "847-245-8448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "81 E Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Fox Lake",
            "state": "IL",
            "postal_code": "600201557",
            "country_code": "US",
            "telephone_number": "847-587-0115",
            "fax_number": "847-587-6246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCCI",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36-065644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100005757",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtucci42428@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "81 E Grand Ave",
            "city": "Fox Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600201557",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "81 E Grand Ave",
            "city": "Fox Lake",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600201557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

Verify at the official NPI Registry.