Individual
DR. CLARK MICHAEL BUESCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1524 W. GLEN AVENUE, PEORIA, IL 61614
(309) 692-3800
(309) 692-4478
Mailing address
1524 W. GLEN AVENUE, PEORIA, IL 61614
(309) 692-6800
(309) 692-4478
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-3404
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072-82005
BCBS
IL
Enumeration date
11/29/2006
Last updated
02/26/2019
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