MEDICARE: DR. JILL RENEE CHERRY-BUKOWIEC MD

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	2086S0102X	Surgical Critical Care Physician	35.090818	OH
2	2086P0122X	Physician Nutrition Specialist (Surgery)	35.090818	OH
3	208600000X	Surgery Physician	35.090818	OH
4	2086S0127X	Trauma Surgery Physician	35.090818	OH

General Provider Information

NPI Number	:	1972724847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JILL RENEE CHERRY-BUKOWIEC MD

Provider Business Mailing Address
First Line	:	3000 ARLINGTON AVE
Second Line	:	MAIL STOP 1108
City	:	TOLEDO
State	:	OH
Zip	:	43614-2598
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 ARLINGTON AVE STE 2C
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-2598
Country	:	US
Telephone Number	:	419-383-3759
Fax Number	:	419-383-2962

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

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	01/21/2026

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