Ronald B Bukowy, M.D. SC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

036052366 Issued in IL

Practice address

2700 Keslinger Rd
Suite B
Geneva, IL 60134-4645

Phone

(630) 262-1500

Fax

(630) 262-1518

NPI assigned

Aug 4, 2006

Sex

Male

Sole proprietor

Yes

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.

• Tri City Balance Center S.C.

  • Specialist
  • Geneva, IL
  • NPI 1780710194
  NPD (past) Authorized official
• Anchor Counseling Inc.

  • Community/Behavioral Health Agency
  • Geneva, IL
  • NPI 1982147880
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 2, 2013.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1922016765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 KESLINGER RD",
            "address_2": "SUITE B",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344645",
            "telephone_number": "630-262-1500",
            "fax_number": "630-262-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 KESLINGER RD",
            "address_2": "SUITE B",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344645",
            "telephone_number": "630-262-1500",
            "fax_number": "630-262-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUKOWY",
        "first_name": "RONALD",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D. SC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-04",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "036052366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HFN",
            "identifier": "036-3996904",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0004500696",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036052366",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie S. Bruno, LMT
• Chrstine V Bruun, PHD
• Melissa Buckley, PT, MSPT, DPT
• Building Blocks Therapy LTD
• Building Blocks Therapy, LTD.
• Randall D Burggraf
• Melissa Burke, APRN, CNP
• Steven Burken, PT
• Kristina Nichole Bustamante, PHD, MA, BS, CCC-SLP
• Lynn Ann Butler

• All providers in Geneva, IL
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; 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.