Individual
DR. ABRAHAM J BRONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4440 W 95TH STREET, OAK LAWN, IL 60653
(708) 346-5520
Mailing address
1912 NORTH HUDSON AVENUE, CHICAGO, IL 60614
(312) 587-3510
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
036069940
IL
2085R0202X
Diagnostic Radiology Physician
Primary
036069940
IL
2085R0202X
Diagnostic Radiology Physician
40213
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036069940
—
IL
05
—
7100012610
—
KY
01
—
P00197522
RAILROAD MEDICARE
IL
01
—
P00928221
RR MEDICARE
KY
Enumeration date
03/10/2006
Last updated
11/03/2015
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