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Individual

WILLIAM R BUCKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 647-9652
Mailing address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-5302

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0360851714
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0062839
UMWA
IL
01
014155
HEALTH ALLIANCE
IL
01
02922981
BCBS
IL
05
036085171
IL
01
085171
OSF HEALTHPLANS
IL
01
1942315197
NPI CLINIC NUMBER
IL
01
200397
BLACK LUNG
IL
01
222121
HEALTH LINK
IL
01
CG5172
RR MEDICARE
01
IL0116
JOHN DEERE
IL
Enumeration date
08/25/2006
Last updated
07/25/2011
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