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General NPI Number Information
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NPI Number | 1619679404
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Entity Type | Individual
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Provider Name | KADIR BUYUKCELEBI MD
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Gender | Male
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Dates
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Enumeration Date | 03/17/2023
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 4646 N MARINE DR INTERNAL MEDICINE DEPARTMENT
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City | CHICAGO
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State | IL
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Zip | 60640
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Country | US
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Telephone | 773-878-8700
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Fax |
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Provider Business Mailing Address
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Address Line | 811 W AGATITE AVE APT 2416
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City | CHICAGO
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State | IL
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Zip | 60640-6214
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Country | US
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Telephone | 773-815-3792
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125081113
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License Number State | IL
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