Provider Demographics
NPI:1336406651
Name:BUENGER, ERIN M (DPT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:BUENGER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2869 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4201
Mailing Address - Country:US
Mailing Address - Phone:773-665-9950
Mailing Address - Fax:
Practice Address - Street 1:2869 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4201
Practice Address - Country:US
Practice Address - Phone:773-665-9950
Practice Address - Fax:773-665-9947
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070018617225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL12562671OtherCAQH