Individual
AMANDA BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1225 W LAKE ST, MELROSE PARK, IL 60160-4039
(708) 938-4000
Mailing address
506 N CUYLER AVE APT 2, OAK PARK, IL 60302-2378
(630) 740-8243
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036136914
IL
207R00000X
Internal Medicine Physician
125060715
IL
Other
Enumeration date
01/12/2012
Last updated
10/08/2015
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