Individual
AMANDA BUDACH
Active
Individual
AMANDA BUDACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070015359
IL
225100000X
Physical Therapist
Primary
8812
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
BCBS IL GROUP
IL
01
—
568080
MEDICARE GROUP NUMBER
IL
01
—
CD3789
MEDICARE RAILROAD GROUP NUMBER
IL
01
—
P00623070
MEDICARE RAILROAD NUMBER
IL
Enumeration date
08/21/2007
Last updated
11/13/2017
Update your record
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