Individual provider · Type 1 NPI

Marie Ellen Buckanavage

Student in an Organized Health Care Education/Training Program · Chicago, IL

NPI number 1316466360 Active

Practice location

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

Call (312) 633-5890 Map

Mailing address

3919 N Ravenswood Ave Apt 2
Chicago, IL 60613-2419

Other practice locations

  • 1431 N Claremont Ave Fl 2, Chicago, IL 60622-1702 · (312) 633-5890

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1316466360

Marie Ellen Buckanavage's National Provider Identifier is 1316466360, issued on Sep 11, 2017. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Chicago, IL. The record was last updated on Mar 17, 2018.