Provider Demographics
NPI:1760460034
Name:BUESER, RUDSEN M (MD)
Entity type:Individual
Prefix:
First Name:RUDSEN
Middle Name:M
Last Name:BUESER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 SOMERSET RD
Mailing Address - Street 2:
Mailing Address - City:WILLOW BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5446
Mailing Address - Country:US
Mailing Address - Phone:630-986-5489
Mailing Address - Fax:630-986-0358
Practice Address - Street 1:256 SOMERSET RD
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-5446
Practice Address - Country:US
Practice Address - Phone:630-986-5489
Practice Address - Fax:630-986-0358
Is Sole Proprietor?:No
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK34398Medicare ID - Type Unspecified
ILC39764Medicare UPIN
IL611690Medicare ID - Type Unspecified