Provider Demographics
NPI:1447891429
Name:BUIS, KARON M
Entity type:Individual
Prefix:
First Name:KARON
Middle Name:M
Last Name:BUIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7735 S STATE ROUTE 47
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:IL
Mailing Address - Zip Code:60424-6072
Mailing Address - Country:US
Mailing Address - Phone:815-258-2137
Mailing Address - Fax:
Practice Address - Street 1:2400 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-5474
Practice Address - Country:US
Practice Address - Phone:815-258-2137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)