Bromberg, Merrick Jay
Bromberg, Merrick Jay is an individual health care provider with primary practice located at 303 W Lake St Suite 102, Addison IL 60101-2586. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bromberg, Merrick Jay can be contacted via phone (630) 543-3020.Contact Information
Primary practice address
303 W Lake St Suite 102
Addison IL 60101-2586
Phone: (630) 543-3020
Fax: (630) 543-1551
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036-060761 | Illinois |
Profile Details
| NPI number | 1659481778 |
|---|---|
| LBN Legal business name | Bromberg, Merrick Jay |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659481778 | NPPES |
| Illinois | MEDICAID | 036060761 |
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