Thomas Ralph Bruno, M.D.

Individual provider Active NPI Orthopaedic Surgery Physician · Inverness, IL

NPI 1134490485 · NPPES record last updated Jan 18, 2012

Key facts

NPI
1134490485
Entity type
Individual (NPI type 1)
Primary specialty
Orthopaedic Surgery Physician 207X00000X
License
036039865 (IL)
Practice address
1881 Prestwick Dr
Inverness, IL 60067-4650
Phone
(847) 991-0980
Fax
(847) 991-0980
NPI assigned
Jan 18, 2012
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036039865ILMDOrthopaedic Surgery Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036039865 IL Yes

Addresses

Primary practice location

1881 Prestwick Dr
Inverness, IL 60067-4650

Mailing address

1881 Prestwick Dr
Inverness, IL 60067-4650
Phone (847) 991-0980

Other providers in Inverness, IL

All providers in Inverness, IL · Orthopaedic Surgery Physician in Illinois

Sources for this page

Verify at the official NPI Registry.