Provider Demographics
NPI:1972724847
Name:CHERRY-BUKOWIEC, JILL RENEE (MD)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:RENEE
Last Name:CHERRY-BUKOWIEC
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:JILL
Other - Middle Name:RENEE
Other - Last Name:CHERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MS
Mailing Address - Street 1:3000 ARLINGTON AVE
Mailing Address - Street 2:MAIL STOP 1108
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2598
Mailing Address - Country:US
Mailing Address - Phone:419-383-5045
Mailing Address - Fax:
Practice Address - Street 1:3000 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2598
Practice Address - Country:US
Practice Address - Phone:734-936-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.090818208600000X, 2086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care