Individual
BRUCE WILLIAM HALLMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5201 S WILLOW SPRINGS RD, SUITE 220, LA GRANGE, IL 60525
(708) 588-0334
(708) 588-0337
Mailing address
5201 S WILLOW SPRINGS RD, SUITE 220, LA GRANGE, IL 60525
(708) 588-0334
(708) 588-0337
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036055517
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036055517
—
IL
01
—
200005698
RAILROAD MEDICARE
IL
01
—
5151090001
DMERC
IL
Enumeration date
09/15/2006
Last updated
06/10/2009
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