Organization
BURR RIDGE FAMILY PRACTICE , LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PORFIRA CIUNGAN (ARSPECIALIST)
(847) 735-9330
Entity
Organization
Contact information
Practice address
11 SALT CREEK LN STE 125, HINSDALE, IL 60521-2902
(630) 655-1177
Mailing address
11 SALT CREEK LN STE 125, HINSDALE, IL 60521-2902
(630) 655-1177
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2232216
BC/BS OF IL PROVIDER #
IL
Enumeration date
08/22/2006
Last updated
04/20/2008
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