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Individual

TEKEKEE DESHA BUCKNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
17495 LA GRANGE RD, TINLEY PARK, IL 60487-7581
(708) 226-7000
Mailing address
1860 PAYSPHERE CIR, CHICAGO, IL 60674-7054
(630) 469-2000

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209009101
IL
363LF0000X
Family Nurse Practitioner
263LF0000X
IL

Other

Enumeration date
09/22/2011
Last updated
12/31/2020
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