Individual
MR. PETER BRUKASZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10510 S ROBERTS RD, PALOS HILLS, IL 60465-1934
(630) 401-7102
(630) 566-6879
Mailing address
10510 S ROBERTS RD, PALOS HILLS, IL 60465-1934
(630) 401-7102
(630) 566-6879
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
036111722
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621679
BCBS OF IL
IL
Enumeration date
11/28/2005
Last updated
01/03/2017
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