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NPI Code Detail

MEDICARE: MICHELLE M BUCK RN, CNS

MEDICARE: MICHELLE M BUCK RN, CNS
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
1163WX0800XOrthopedic Registered Nurse41249740IL
2364S00000XClinical Nurse Specialist209000004IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CA4748OTHERILMEDICARE RAILROAD PTAN (GROUP)
2P01334027OTHERILMEDICARE RAIL ROAD PTAN (INDIVIDUAL)

General Provider Information

NPI Number : 1982621421
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE M BUCK RN, CNS
Provider Business Mailing Address
First Line : 27650 FERRY RD
Second Line :
City : WARRENVILLE
State : IL
Zip : 60555-3845
Country : US
Telephone Number : 630-225-2663
Fax Number : 630-225-2399
Provider Business Practice Location Address
First Line : 27650 FERRY RD
Second Line :
City : WARRENVILLE
State : IL
Zip : 60555-3845
Country : US
Telephone Number : 630-225-2663
Fax Number : 630-225-2399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2006
Last Update Date : 12/30/2014

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