Individual
MICHELLE M BUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CNS
Contact information
Practice address
27650 FERRY RD, WARRENVILLE, IL 60555-3845
(630) 225-2663
(630) 225-2399
Mailing address
27650 FERRY RD, WARRENVILLE, IL 60555-3845
(630) 225-2663
(630) 225-2399
Taxonomy
Speciality
Code
Description
License number
State
163WX0800X
Orthopedic Registered Nurse
41249740
IL
364S00000X
Clinical Nurse Specialist
Primary
209000004
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA4748
MEDICARE RAILROAD PTAN (GROUP)
IL
01
—
P01334027
MEDICARE RAIL ROAD PTAN (INDIVIDUAL)
IL
Enumeration date
07/17/2006
Last updated
12/30/2014
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