Organization
BROMENN PHYSICIAN MANAGEMENT CORPORATION
Active
Other names
Illinois Heart & Lung Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM BROUWER (PRESIDENT, PHYSICIANS MGMNT CORP)
(309) 268-2129
Entity
Organization
Contact information
Practice address
1302 FRANKLIN AVE, SUITE 4500, NORMAL, IL 61761-3551
(309) 828-1166
(309) 862-0330
Mailing address
1302 FRANKLIN AVE, SUITE 4500, NORMAL, IL 61761-3551
(309) 828-1166
(309) 862-0330
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05732097
BCBS GROUP NUMBER
IL
01
—
212636
MEDICARE GROUP NUMBER
IL
Enumeration date
07/09/2006
Last updated
04/20/2008
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