Provider Demographics
NPI:1841225349
Name:BUCH, PIYUSH C (MD)
Entity Type:Individual
Prefix:
First Name:PIYUSH
Middle Name:C
Last Name:BUCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7480 W COLLEGE DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1165
Mailing Address - Country:US
Mailing Address - Phone:708-361-0540
Mailing Address - Fax:708-361-1897
Practice Address - Street 1:7480 W COLLEGE DR
Practice Address - Street 2:SUITE 203
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1165
Practice Address - Country:US
Practice Address - Phone:708-361-0540
Practice Address - Fax:708-361-1897
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360575022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036057502Medicaid
IL692531Medicare ID - Type Unspecified
IL036057502Medicaid