Paul H Bonucci, MD

Primary specialty

Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X

License

036100221 Issued in IL

Practice address

2128 N Main St
Princeton, IL 61356-9728

Phone

(815) 875-2273

Fax

(815) 207-8682

NPI assigned

Aug 22, 2006

Last updated

Jun 9, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: paul.bonucci@perry.cernerdirect.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Ihcc Hospice Inc

  dba In-Home Care Connection Hospice Services

  • Community Based Hospice Care Agency
  • Princeton, IL
  • NPI 1114525243

  Contracted Managing Employee

  CMS ownership

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

• Ihcc Hospice Inc

  dba IHCC Healthcare

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Princeton, IL
  • NPI 1023716875
  Medicare reassignment NPD
• Osf Healthcare System

  dba Osf Holy Family Clinics

  • Rural Health Clinic/Center
  • Monmouth, IL
  • NPI 1679606073
  Medicare reassignment NPD
• Princeton Prompt Care LLC

  • Urgent Care Clinic/Center
  • Princeton, IL
  • NPI 1477848521
  Authorized official Same address or phone
• Osf Healthcare System

  dba OSF HealthCare - Community Health

  • Rural Health Clinic/Center
  • Princeton, IL
  • NPI 1417542804
  NPD
• Osf Healthcare System

  dba OSF Saint Katharine Medical Center

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1508683590
  NPD
• Csra Emergency Physicians, PC

  • Emergency Medicine Physician
  • Augusta, GA
  • NPI 1447352778
  NPD (past)
• Cyrus Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Augusta, GA
  • NPI 1568412294
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1922114677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 PRAIRIE LN S",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613562383",
            "telephone_number": "815-915-6435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 N MAIN ST",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613569728",
            "telephone_number": "815-875-2273",
            "fax_number": "815-207-8682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1124 Prairie Ln S",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "IL",
            "postal_code": "613562383",
            "country_code": "US",
            "telephone_number": "815-915-6435",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "530 Park Ave E",
            "address_purpose": "LOCATION",
            "city": "Princeton",
            "state": "IL",
            "postal_code": "61356",
            "country_code": "US",
            "telephone_number": "815-875-2811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BONUCCI",
        "first_name": "PAUL",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "IL",
            "license": "036100221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G48980",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100221",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "paul.bonucci@perry.cernerdirect.com",
            "affiliation": "N",
            "address_1": "530 Park Ave E",
            "city": "Princeton",
            "state": "IL",
            "country_code": "US",
            "postal_code": "61356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexandria Bertolino, D.C.
• Elizabeth Marie Birkey, CNM, FNP-C, PMHNP-BC
• Christopher Thomas Blanford, M.D.
• BMP Tri Co Spec Educ Coop
• Bobrowski Industries Princeton LLC (Fawcetts Pharmacy)
• Elyse J Boroski
• Shirley M Borys, LPC
• Bureau County Family Health
• Bureau County Family Health
• Bureau Valley Anesthesia Group, Inc.

• Addiction Medicine (Preventive Medicine) Physician in Princeton, IL
• Providers in Princeton, IL by specialty
• Addiction Medicine (Preventive Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.