Individual
DR. MICHAEL PURUCKHERR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1340 CHARLES ST STE 405, ROCKFORD, IL 61104-2200
(779) 696-6102
Mailing address
700 NE 87TH AVE, VANCOUVER, WA 98664-1913
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD00043378
WA
207RP1001X
Pulmonary Disease Physician
0101266905
VA
207RP1001X
Pulmonary Disease Physician
Primary
036-161516
IL
207RP1001X
Pulmonary Disease Physician
2021046940
MO
207RP1001X
Pulmonary Disease Physician
MD00043378
WA
207RS0012X
Sleep Medicine (Internal Medicine) Physician
MD00043378
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036161516
—
IL
05
—
1120898
—
WA
05
—
200104425
—
MO
05
—
7047629
—
WA
01
—
AB32999
MEDICARE GROUP
WA
Enumeration date
07/04/2006
Last updated
03/04/2026
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