Provider Demographics
NPI:1013217249
Name:BUONO, CYNTHIA ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:ANN
Last Name:BUONO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3660 N LAKE SHORE DR STE 210
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-5302
Mailing Address - Country:US
Mailing Address - Phone:312-772-1133
Mailing Address - Fax:
Practice Address - Street 1:3660 N LAKE SHORE DR STE 210
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613
Practice Address - Country:US
Practice Address - Phone:312-772-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2018-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11014608A208600000X
WI6694321208600000X
OH34.011150208600000X
IL036133475208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214881Medicare Oscar/Certification