Individual
DEBRA BUFFETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5454 S SHORE DR APT 922, CHICAGO, IL 60615-5995
(773) 213-8495
Mailing address
5454 S SHORE DR APT 922, CHICAGO, IL 60615-5995
(773) 213-8495
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
2355S0801X
Speech-Language Assistant
217000107
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103034
—
IL
Enumeration date
04/04/2007
Last updated
11/02/2020
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