Individual
CHARLES DRUECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 YALE CT, GLENVIEW, IL 60026-5916
(847) 272-4682
(847) 272-4691
Mailing address
5501 W 79TH ST STE 400, BURBANK, IL 60459-2190
(773) 884-4500
(773) 884-4580
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036045746
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632718
BLUE SHIELD
IL
01
—
020052114
RAILROAD MEDICARE
—
05
—
036045746
—
IL
Enumeration date
07/26/2006
Last updated
12/19/2013
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