ANDREA ANN IANTORNO BUCKLEY


Address: 9000 N Waukegan Road, Suite 130, Morton Grove, IL 60053-2127
Phone: 8474708740

ANDREA ANN IANTORNO BUCKLEY (NPI# 1356433940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356433940
Entity Type Individual
Full Name ANDREA ANN IANTORNO BUCKLEY
Credential APRN BC
Practice Address 9000 N Waukegan Road
Suite 130
Morton Grove
IL 60053-2127
Mailing Address 1121 Lake Cook Road
Suite M
Deerfield
IL 60015-5234
Practice Telephone 8474708740
Mailing Telephone 8479454550
Mailing Fax Number 8479488103
Enumeration Date 2006-09-29
Last Update Date 2011-11-16
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163WP0000X Registered Nurse
Specialization: Pain Management
309001889 IL Nursing Service Providers
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
209004590 IL Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 9000 N WAUKEGAN ROAD
SUITE 130
City MORTON GROVE
State IL
Zip Code 60053-2127

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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

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Competitor

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City MORTON GROVE
Zip Code 60053

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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