Individual
MARK EDWARD RUNGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
518 HILLGROVE AVENUE, SUITE 100, WESTERN SPRINGS, IL 60558-1480
(708) 246-8881
(708) 246-6858
Mailing address
518 HILLGROVE AVENUE, SUITE 100, WESTERN SPRINGS, IL 60558-1480
(708) 246-8881
(708) 246-6858
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019017664
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
021001388
IL
Other
Enumeration date
03/05/2007
Last updated
03/26/2021
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