Individual
DR. MERRICK JAY BROMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
303 W LAKE ST, SUITE 102, ADDISON, IL 60101-2586
(630) 543-3020
(630) 543-1551
Mailing address
303 W LAKE ST, SUITE 102, ADDISON, IL 60101-2586
(630) 543-3020
(630) 543-1551
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-060761
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036060761
—
IL
Enumeration date
08/30/2006
Last updated
07/08/2007
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