Healthcare Provider Details

I. General information

NPI: 1043050362
Provider Name (Legal Business Name): NAJAH BUCK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2024
Last Update Date: 05/27/2024
Certification Date: 05/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N MICHIGAN AVE STE 201
CHICAGO IL
60601-7940
US

IV. Provider business mailing address

530 W ARLINGTON PL APT 116
CHICAGO IL
60614-5989
US

V. Phone/Fax

Practice location:
  • Phone: 312-819-7381
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: