William L Buntain, MD

Primary specialty

Pediatric Surgery PhysicianTaxonomy code 2086S0120X

License

04-23862 Issued in KS

Practice address

2350 N Rockton Ave
Rockford, IL 61103-3600

Phone

(815) 971-7255

Fax

(815) 971-9955

NPI assigned

Mar 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479772800000",
    "number": "1700902608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N ROCKTON AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033600",
            "telephone_number": "815-971-7255",
            "fax_number": "815-971-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNTAIN",
        "first_name": "WILLIAM",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-22",
        "last_updated": "2016-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "20030056",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036131963",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "KS",
            "license": "04-23862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35326751",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Bullis, M.D.
• Eric D Bullock, M.D.
• Heidi S Bullock, RPH
• Terry Lynn Bunger
• Alexandra Bunjan, LSW
• Jody Lynn Buntjer, RDH
• Brittany Anne Bunton, LCPC
• Jeffrey V Burch, D.M.D.
• Todd D Burd, LCPC
• Mary Ann Buresh

• Pediatric Surgery Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Pediatric Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2016; 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.