Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | IL | |
N | 2086S0122X | Plastic and Reconstructive Surgery | IL |
NPI | 1447352620 |
---|---|
Provider Name | John Joseph Bulger II |
First Address | Hinsdale, IL 60521-3543 |
Second Address | Hinsdale, IL 60521-3543 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I24797 | (02) |