Individual
MICHELE BUCCIERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7464 N CLARK ST, CHICAGO, IL 60626-1620
(773) 381-8700
(773) 381-8701
Mailing address
7464 N CLARK ST, CHICAGO, IL 60626-1620
(773) 381-8700
(773) 381-8701
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-113341
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036-113341
STATE LICENSE
IL
Enumeration date
08/30/2006
Last updated
05/06/2012
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