Individual
DR. DWAYNE BERNARD BUCHANAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
220 SPRINGFIELD DR STE 210, BLOOMINGDALE, IL 60108-2215
(630) 893-2213
(630) 307-0482
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036124946
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036124946
—
IL
01
—
F400436681
MEDICARE
IL
01
—
P01953171
RRM
IL
Enumeration date
01/13/2009
Last updated
02/09/2024
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