Individual
MR. PHILIP CHARLES BODENSTAB JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1044 N FRANCISCO AVENUE, NORWEGIAN AMERICAN HOSPITAL, CHICAGO, IL 60622
(773) 278-8800
Mailing address
341 N STEWART AVE, LOMBARD, IL 60148
(630) 611-8029
(630) 691-1216
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
G21779
CA
207L00000X
Anesthesiology Physician
MD00015200
WA
207L00000X
Anesthesiology Physician
ME63662
FL
207L00000X
Anesthesiology Physician
Primary
—
IL
Other
Enumeration date
07/07/2006
Last updated
07/08/2007
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