Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 036-062475 | IL |
NPI | 1013918473 |
---|---|
Provider Name | Dr. Bruce M Abramowitz |
First Address | Oak Lawn, IL 60453-2401 |
Second Address | Oak Lawn, IL 60453-6458 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2005 |
Last Update Date | 18/09/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036032475 | (05) | IL |
060053888 | PALMETTO GBA INIVIDUAL # (01) | IL |
21622931 | BCBS GROUP # (01) | IL |
A66998 | (02) | IL |
CI8250 | PALMETTO GBA GROUP # (01) | IL |