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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659481778 NPPES
Illinois MEDICAID 036060761

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