Pulmonary Medicine Associates SC

Organization Active NPI Critical Care Medicine (Internal Medicine) Physician · Melrose Park, IL

NPI 1376576785 · NPPES record last updated Jan 19, 2012

Key facts

NPI
1376576785
Entity type
Organization (NPI type 2)
Primary specialty
Critical Care Medicine (Internal Medicine) Physician 207RC0200X
Legal business name
PULMONARY MEDICINE ASSOCIATES SC
Practice address
675 W North Ave
Melrose Park, IL 60160-1634
Phone
(708) 450-4557
NPI assigned
Jul 9, 2006
Organization subpart
No

Authorized official

Name
Ms. Elizabeth M Brundage
Title
Director
Phone
(708) 366-7177

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050616000572 IL Part B Supplier - Clinic/Group Practice 3476597881 Receives reassigned benefits from 19 practitioners
Practice locations: Evanston, IL; Melrose Park, IL; Libertyville, IL

National Provider Directory

Locations

800 Austin St
Ste 557E
Evanston, IL 60202

890 Garfield Ave
Ste 209
Libertyville, IL 60048
Phone (847) 362-5535

444 N Northwest Hwy
Ste 206
Park Ridge, IL 60068
Phone (847) 653-6184

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RC0200X Yes
Pulmonary Disease Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RP1001X

Addresses

Primary practice location

675 W North Ave
Melrose Park, IL 60160-1634

Mailing address

7607 Madison St
Forest Park, IL 60130-3513
Phone (708) 366-7177

Other identifiers

IdentifierTypeStateIssuer
31601838OtherILBCBS OF IL

Other providers in Melrose Park, IL

All providers in Melrose Park, IL · Critical Care Medicine (Internal Medicine) Physician in Illinois

Sources for this page

Verify at the official NPI Registry.