NPI: 1063406601 · WAUCONDA, IL 60084 · Family Medicine Physician · NPI assigned 09/09/2005
| Authorized Official | BELLUCCI, JASON (PRACTICE ADMINISTRATOR) |
| NPI Enumeration Date | 09/09/2005 |
| Year | Claims | Total Paid |
|---|---|---|
| 2020 | 19 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 3008F | 19 | 12 | $0.00 |