Desiree Buford, LABORATORY TECH

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

License

J7A2P8J9 Issued in IL

Practice address

4350 211TH St Ste 210a
Matteson, IL 60443-3082

Phone

(708) 405-6864

NPI assigned

Mar 9, 2023

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1992405682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4350 211TH ST STE 210A",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433082",
            "telephone_number": "708-405-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 211TH ST STE 210A",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433082",
            "telephone_number": "708-405-6864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUFORD",
        "first_name": "DESIREE",
        "credential": "LABORATORY TECH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "IL",
            "license": "J7A2P8J9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Matteson, IL
• Phlebotomy Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.