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Individual

RENE SHERWIN PARUNGAO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4309 W MEDICAL CENTER DR STE B202, MCHENRY, IL 60050
(815) 455-2752
(815) 455-2789
Mailing address
4309 W MEDICAL CENTER DR STE B202, MCHENRY, IL 60050-8417
(815) 455-2752
(815) 455-2789

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036115790
IL
208600000X
Surgery Physician
2013030325
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036115790
STATE LICENSE
IL
05
1942231667
MO
01
718000036
MEDICARE MO
MO
01
K29524
MEDICARE ID#
IL
Enumeration date
07/05/2006
Last updated
03/18/2019
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