Individual
MR. MARTIN WILLIAM BUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
225 E CHICAGO AVE # 46, CHICAGO, IL 60611-2991
(312) 227-6210
(312) 227-9429
Mailing address
225 E CHICAGO AVE # 46, CHICAGO, IL 60611-2991
(312) 227-6210
(312) 227-9429
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
211.000186
IL
174400000X
Specialist
Primary
213.000220
IL
Other
Enumeration date
01/13/2010
Last updated
08/22/2019
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