Individual
KILEY LANE BUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4646 N MARINE DR, CHICAGO, IL 60640-5759
(773) 564-5355
Mailing address
4121 N MOZART ST, CHICAGO, IL 60618-2708
(217) 741-0404
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041 342623
IL
163W00000X
Registered Nurse
2006003604
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
209008047
IL
Other
Enumeration date
02/16/2010
Last updated
03/01/2023
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