Healthcare Provider Details

I. General information

NPI: 1528019742
Provider Name (Legal Business Name): SUSAN E. BUECHELE DNP, APRN, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 S 1ST AVE RM 86B
MAYWOOD IL
60153-2307
US

IV. Provider business mailing address

807 S 1ST AVE RM 86B
MAYWOOD IL
60153-2307
US

V. Phone/Fax

Practice location:
  • Phone: 708-668-9067
  • Fax: 708-668-9067
Mailing address:
  • Phone: 708-668-9067
  • Fax: 708-668-9067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number209003900
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: