Yaimet Vidal Bucknor, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

036123195 Issued in IL

Practice address

4500 Memorial Dr
Belleville, IL 62226-5360

Phone

(618) 257-6220

NPI assigned

May 6, 2009

Last updated

Oct 21, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Humboldt Park HealthGroup PAC ID 8921907072, 106 clinicians

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Osf Saint Katharine Medical Center Hospital, Dixon, IL, CCN 140012
• Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 37)

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

• Humboldt Park Health

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1740417153

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• 24 On Physicians, PC

  • Hospitalist Physician
  • Ottawa, IL
  • NPI 1346480431
  Medicare reassignment NPD
• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Allergy & Immunology Physician
  • Evanston, IL
  • NPI 1497701882

  Internal Medicine

  Medicare reassignment NPD
• Illinois Department of Human Services

  • Intellectual Disabilities Intermediate Care Facility
  • Centralia, IL
  • NPI 1003960394
  Medicare reassignment NPD
• Inpatient Consultants of Illinois, P.C.

  • Hospitalist Physician
  • Hinsdale, IL
  • NPI 1548442569

  Internal Medicine

  Medicare reassignment NPD
• KND Development 59 LLC

  • Hospitalist Physician
  • Chicago, IL
  • NPI 1992034599
  Medicare reassignment NPD
• Midwest Emergency Anderson Health, Inc

  • Emergency Medicine Physician
  • Staunton, IL
  • NPI 1710647615
  Medicare reassignment NPD
• Morris Hospital

  • General Practice Physician
  • Morris, IL
  • NPI 1558466268
  Medicare reassignment NPD
• Northwest Community Health Services Inc

  dba NCH Medical Group

  • Internal Medicine Physician
  • Arlington Heights, IL
  • NPI 1134433154
  Medicare reassignment NPD
• Northwestern Medical Faculty Foundation

  dba Northwestern Medical Group

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314
  Medicare reassignment NPD
• Rockford Health Physicians

  dba Mercyhealth Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Osf Healthcare System

  dba OSF Saint Katharine Medical Center

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1508683590
  Care Compare affiliation
• Saint Anthony Medical Center

  dba OSF Saint Anthony Medical Center

  • General Acute Care Hospital
  • Rockford, IL
  • NPI 1790739977
  Care Compare affiliation

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1902030836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2650 RIDGE AVE STE 1223",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011700",
            "telephone_number": "847-570-2040",
            "fax_number": "847-733-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 MEMORIAL DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265360",
            "telephone_number": "618-257-6220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12935 Gregory St",
            "address_purpose": "LOCATION",
            "city": "Blue Island",
            "state": "IL",
            "postal_code": "604062428",
            "country_code": "US",
            "telephone_number": "708-597-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 W Central Rd",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600052349",
            "country_code": "US",
            "telephone_number": "877-635-9229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "155 E Brush Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "IL",
            "postal_code": "601265658",
            "country_code": "US",
            "telephone_number": "331-221-8952",
            "fax_number": "331-221-3782",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUCKNOR",
        "first_name": "YAIMET",
        "middle_name": "VIDAL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-06",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036123195",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036123195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036123195",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4500 Memorial Dr",
            "city": "Belleville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622265360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachel Brunnworth
• Kyle Brunsmann, MSR, LMT
• Shelia Bryson, DDS
• Christopher Kenneth Buchheit, PHARM D
• Lucas Kyle Buckley, MD
• Bradley Joseph Budde, MD
• Mary Buehler
• Mary Buehne, OTR/L
• Jacqueline Elaine Bullard, OD
• Kayla Jean Bumpus, PT, DPT

• Hospitalist Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Hospitalist Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.