Marie Ellen Buckanavage

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

1431 N Claremont Ave FL 2
Chicago, IL 60622-1702

Phone

(312) 633-5890

NPI assigned

Sep 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1316466360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3919 N RAVENSWOOD AVE APT 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132419",
            "telephone_number": "203-640-2402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N CLAREMONT AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221702",
            "telephone_number": "312-633-5890"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1431 N Claremont Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606221702",
            "country_code": "US",
            "telephone_number": "312-633-5890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKANAVAGE",
        "first_name": "MARIE",
        "middle_name": "ELLEN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiley Lane Buck
• Najah Buck
• Ryan James Buck, M.D.
• Shirley Buck
• Stacey Buck
• Buckingham Pavilion Inc
• Buckingham Pavilion Inc
• Anne Janssen Buckingham, PH.D.
• Deborah L Buckingham, M.D.
• Catherine Marie Buckley, MD

• Student in an Organized Health Care Education/Training Program in Chicago, IL
• Providers in Chicago, IL by specialty
• Student in an Organized Health Care Education/Training Program in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.