Provider Demographics
NPI:1356588099
Name:OBERLE, BUFFI SUE (APN-C, RN)
Entity type:Individual
Prefix:MRS
First Name:BUFFI
Middle Name:SUE
Last Name:OBERLE
Suffix:
Gender:F
Credentials:APN-C, RN
Other - Prefix:MRS
Other - First Name:BUFFI
Other - Middle Name:SUE
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:600 S 13TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:PEKIN
Mailing Address - State:IL
Mailing Address - Zip Code:61554-4936
Mailing Address - Country:US
Mailing Address - Phone:309-353-0333
Mailing Address - Fax:309-353-0341
Practice Address - Street 1:600 S 13TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:PEKIN
Practice Address - State:IL
Practice Address - Zip Code:61554-4936
Practice Address - Country:US
Practice Address - Phone:309-353-0333
Practice Address - Fax:309-353-0341
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007169363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics