Individual
STEPHANIE BUCZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1200 S YORK ST, ELMHURST, IL 60126-5626
(331) 221-6140
Mailing address
1200 S YORK ST, ELMHURST, IL 60126-5626
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.009074
IL
133V00000X
Registered Dietitian
8890
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164.009074
STATE LICENSE
IL
01
—
8890
STATE LICENSE
FL
Enumeration date
10/04/2018
Last updated
03/13/2023
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