Individual
RONALD S STUMBRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11950 S HARLEM AVE, SUITE 101, PALOS HEIGHTS, IL 60463-1150
(708) 448-9450
Mailing address
12103 S 69TH AVE, PALOS HEIGHTS, IL 60463-1621
(708) 448-0870
(708) 448-6720
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
036-088148
IL
208D00000X
General Practice Physician
Primary
036-088148
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633957
BCBS PROVIDER
IL
Enumeration date
12/18/2006
Last updated
03/07/2012
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