MEDICARE: DR. WILLIAM L. BUCHAR III D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	038-010110	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2232610	OTHER	IL	BLUE SHIELD PROVIDER #

General Provider Information

NPI Number	:	1790788792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM L. BUCHAR III D.C.

Provider Business Mailing Address
First Line	:	3015 E NEW YORK ST
Second Line	:	STE A12
City	:	AURORA
State	:	IL
Zip	:	60504-5163
Country	:	US
Telephone Number	:	630-820-1330
Fax Number	:

Provider Business Practice Location Address
First Line	:	3075 BOOK RD
Second Line	:	STE 167
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-4721
Country	:	US
Telephone Number	:	630-857-3542
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	10/12/2019

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