NPI 1174666192 · live from the CMS NPI Registry
Alex J Buividas & Thomas A Buividas Ptr
Podiatrist in Chicago, IL. National Provider Identifier 1174666192, active.
NPI record
| NPI | 1174666192 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Podiatrist 213E00000X |
| Practice location | 4554 S Archer Ave, Chicago, IL 60632 |
| Practice phone | 773-847-6784 |
| Enumerated | February 15, 2007 |
| Last updated | September 11, 2008 |
| Authorized official | Thomas Buividas, Partner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist primary | 213E00000X | 016002967 (IL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.