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Organization
THOMAS A RUNNE DPM LTD
Active
Organization
THOMAS A RUNNE DPM LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA BOMBARD (BILLING DIRECTOR)
(630) 897-6851
Entity
Organization
Contact information
Practice address
1437 S BELL SCHOOL RD STE 2, ROCKFORD, IL 61108-1405
(815) 284-2023
Mailing address
1955 W DOWNER PL, AURORA, IL 60506-4384
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004049
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0060101287
BCBS
IL
05
—
016004049
—
IL
01
—
914510
MEDICARE GROUP
—
01
—
CG7104
RAIL ROAD MEDICARE
IL
Enumeration date
10/02/2007
Last updated
03/03/2009
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