Brundidge, William
Brundidge, William is an sole proprietor health care provider with primary practice located at 2160 S 1St Ave Loyola University Medical Center, Maywood IL 60153-3328. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Brundidge, William can be contacted via phone (708) 216-4943.Contact Information
Primary practice address
2160 S 1St Ave Loyola University Medical Center
Maywood IL 60153-3328
Phone: (708) 216-4943
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 125070650 | Illinois |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 125070650 | Illinois |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | Illinois |
Profile Details
| NPI number | 1932633500 |
|---|---|
| LBN Legal business name | Brundidge, William |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 20th, 2017 |
| Last updated | Aug 13th, 2017 - about 9 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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