| Stephen J Bundra Md Sc | |
|
1921 Lake Ave Ste B Wilmette IL 60091-1480 | |
| (847) 853-9104 | |
| Not Available |
| Full Name | Stephen J Bundra Md Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1921 Lake Ave Ste B, Wilmette, Illinois |
| Authorized Official Name and Position | Stephen J Bundra (PRESIDENT) |
| Authorized Official Contact | 8478539104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephen J Bundra Md Sc 1921 Lake Ave Ste B Wilmette IL 60091-1480 Ph: (847) 853-9104 | Stephen J Bundra Md Sc 1921 Lake Ave Ste B Wilmette IL 60091-1480 Ph: (847) 853-9104 |
| NPI Number | 1770638959 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 02/21/2024 |
| Medicare PECOS PAC ID | 3779574728 |
|---|---|
| Medicare Enrollment ID | O20040722000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770638959 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036069601 (Illinois) | Primary |
| Provider Name | Stephen J Bundra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326064387 PECOS PAC ID: 0648261693 Enrollment ID: I20040726000019 |
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