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Contact Information

ALEX J BUIVIDAS & THOMAS A BUIVIDAS PTR
4554 S ARCHER AVE
CHICAGO, IL60632-2954
 Phone: 773-847-6784
 Fax: 773-847-6883
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for ALEX J BUIVIDAS & THOMAS A BUIVIDAS PTR

NPI # 1174666192
LBN Legal business name ALEX J BUIVIDAS & THOMAS A BUIVIDAS PTR
Authorized official THOMAS BUIVIDAS - (PARTNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/15/2007
Last updated 09/11/2008 - About 18 years ago
Identifiers
IL License # 016002967
IL Medicaid 016002967
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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