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Individual

MR. BRIAN BUENAVENTURA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APN CRNA

Contact information

Practice address
1901 W HARRISON ST, CHICAGO, IL 60612-3714
(312) 864-3215
Mailing address
3547 N WILTON AVE, UNIT 2N, CHICAGO, IL 60657-1708

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209004759
IL

Other

Enumeration date
07/19/2006
Last updated
04/22/2021
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