Michelle Bunch
Individual provider Active NPI Specialist · Freeport, IL
NPI 1982636775 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1982636775
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- Practice address
- 421 W Exchange St
Freeport, IL 61032-4030 - Phone
- (815) 599-7300
- NPI assigned
- Jul 6, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Yes |
Addresses
Primary practice location
421 W Exchange St
Freeport, IL 61032-4030
Mailing address
PO Box 813
1255 W Empire
Freeport, IL 61032-0813
Other providers in Freeport, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.