Individual
ANNA BUNPLOOG-LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6301 N WESTERN AVE, CHICAGO, IL 60659-2009
(773) 761-0300
Mailing address
3120 EMERSON ST, FRANKLIN PARK, IL 60131-2621
(847) 671-0380
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-110715
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635798
BCBS
IL
05
—
036110715
—
IL
Enumeration date
10/24/2006
Last updated
04/22/2025
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