Individual provider Active NPI

Amanda Buck, DO

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1104481332
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036.165432 Issued in IL
Practice address
5215 N California Ave FL 7
Chicago, IL 60625-7014
Phone
(312) 666-3494
NPI assigned
May 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036.165432 IL Primary

Addresses

Primary practice location

5215 N California Ave FL 7
Chicago, IL 60625-7014

Mailing address

5215 N California Ave FL 7
Chicago, IL 60625-7014
Phone (312) 666-3494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231018000226 IL Practitioner - Obstetrics/Gynecology 8123356987 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erie Family Health Center, IncGroup PAC ID 9537050422, 141 clinicians
Bonaventure Medical Foundation LLCGroup PAC ID 7517863178, 164 clinicians

Practice addresses (Care Compare)

1701 W Superior St
FL 2
Chicago, IL 60622-5646
Phone (312) 666-3494

1786 Moon Lake Blvd
Hoffman Est, IL 60194-5029
Phone (847) 755-8208

1931 N Meacham Rd
FL 2
Schaumburg, IL 60173-4364
Phone (847) 808-8884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036.165432ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Illinois SC Obstetrics & Gynecology CurrentSince Sep 1, 2024 Accepting new patients
Erie Family Health Center, Inc Current Accepting new patients
Erie Family Health Center Inc CurrentSince Sep 11, 2023 Accepting new patients
Erie Family Health Center Inc CurrentSince Sep 11, 2023 Accepting new patients

Locations

1701 W Superior St
Fl 2
Chicago, IL 60622
Phone (323) 361-2122

5140 N California Ave
Ste 780
Chicago, IL 60625
Phone (773) 784-5140

1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381

5215 N California Ave
Fl 7
Chicago, IL 60625
Phone (312) 386-6346

5140 N California Ave
Chicago, IL 60625
Phone (773) 275-8811

1504 S Albany Ave
Chicago, IL 60623

1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 908-3736

Interoperability endpoints

  • Direct secure messaging: abuck656023@direct.ochin.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1104481332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 N CALIFORNIA AVE FL 7",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257014",
            "telephone_number": "312-666-3494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 N CALIFORNIA AVE FL 7",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606257014",
            "telephone_number": "312-666-3494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCK",
        "first_name": "AMANDA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-02",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036.165432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.