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Individual
DR. JOHN PAUL FEDERBUSCH
Active
Individual
DR. JOHN PAUL FEDERBUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
036056863
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02215674
BCBC-IL GRP PROV # FOR GROUP NAMED: METROPOLITAN MEDICAL CONSULTANTS, S.C.
IL
05
—
036056863
—
IL
01
—
208486
GROUP PROVIDER NUMBER FOR THE GROUP NAMED: CHICAGO UPTOWN MEDICAL CENTER, GROU
IL
01
—
787360
MEDICARE GROUP PROV # FOR GROUP NAMED: METROPOLITAN MEDICAL CONSULTANTS, S.C.
IL
Enumeration date
03/13/2007
Last updated
07/29/2014
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