Individual
BRUCE C CORWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15728 S ROUTE 59, PLAINFIELD, IL 60544-2693
(815) 436-8831
(815) 436-6863
Mailing address
15728 S ROUTE 59, PLAINFIELD, IL 60544-2693
(815) 436-8831
(815) 436-6863
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036068055
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036068055
—
IL
01
—
399980
MEDICARE GROUP PTAN
—
Enumeration date
01/09/2007
Last updated
03/12/2021
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