Individual
DR. BRIAN E LUNDEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 E LAYTON AVE, ST FRANCIS, WI 53235-6053
(414) 744-6589
(414) 747-8848
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
036-088572
IL
2085R0202X
Diagnostic Radiology Physician
036-088572
IL
2085R0202X
Diagnostic Radiology Physician
Primary
30528
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-088572
—
IL
01
—
202926
GROUP PTAN
IL
05
—
31882600
—
WI
Enumeration date
05/10/2006
Last updated
03/24/2025
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