MEDICARE: IONUT CLAUDIU BUGEAG MD

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
1	174400000X	Specialist	036-104629	IL
2	2085R0202X	Diagnostic Radiology Physician	036-104629	IL

General Provider Information

NPI Number	:	1851330252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IONUT CLAUDIU BUGEAG MD

Provider Business Mailing Address
First Line	:	1212 N LASALLE ST
Second Line	:	APT. 1203
City	:	CHICAGO
State	:	IL
Zip	:	60610-8027
Country	:	US
Telephone Number	:	312-751-9106
Fax Number	:

Provider Business Practice Location Address
First Line	:	1212 N LASALLE ST
Second Line	:	APT. 1203
City	:	CHICAGO
State	:	IL
Zip	:	60610-8027
Country	:	US
Telephone Number	:	312-751-9106
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	04/22/2021

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