Organization
PULMONARY MEDICINE ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELIZABETH M BRUNDAGE (DIRECTOR)
(708) 366-7177
Entity
Organization
Contact information
Practice address
675 W NORTH AVE, MELROSE PARK, IL 60160-1634
(708) 450-4557
Mailing address
7607 MADISON ST, FOREST PARK, IL 60130-3513
(708) 366-7177
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31601838
BCBS OF IL
IL
Enumeration date
07/09/2006
Last updated
01/19/2012
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