Organization
FOX VALLEY INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN JAMES BRONGIEL M.D. (ADMINISTRATOR)
(630) 830-1900
Entity
Organization
Contact information
Practice address
403 W IRVING PARK RD, STREAMWOOD, IL 60107-2851
(630) 830-1900
(630) 830-1904
Mailing address
403 W IRVING PARK RD, STREAMWOOD, IL 60107-2851
(630) 830-1900
(630) 830-1904
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21609105
BLUECROSS BLUESHIELD
IL
Enumeration date
04/09/2007
Last updated
07/12/2007
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