Healthcare Provider Details
I. General information
NPI: 1073666061
Provider Name (Legal Business Name): BUCHER MEDICAL SERVICES SC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/21/2007
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2551 N CLARK ST STE 203
CHICAGO IL
60614-7738
US
IV. Provider business mailing address
3023 N CLARK ST STE 200
CHICAGO IL
60657-5200
US
V. Phone/Fax
- Phone: 312-623-2625
- Fax: 773-289-0685
- Phone: 312-623-2625
- Fax: 773-289-0685
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | 036087460 |
| License Number State | IL |
VIII. Authorized Official
Name:
GARY
G
BUCHER
Title or Position: PRESIDENT
Credential: MD
Phone: 312-623-2625