MEDICARE: MR. THOMAS A RUNNE DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	016004049	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	480005945	OTHER	IL	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0060101287	OTHER	IL	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497731293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS A RUNNE DPM

Provider Business Mailing Address
First Line	:	1955 W DOWNER PL
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60506-4384
Country	:	US
Telephone Number	:	815-260-7731
Fax Number	:	630-897-6849

Provider Business Practice Location Address
First Line	:	1437 S BELL SCHOOL RD STE 2
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61108-1405
Country	:	US
Telephone Number	:	815-260-7731
Fax Number	:	630-897-6851

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	03/03/2009

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Directions to “ MR. THOMAS A RUNNE DPM” Practice Location

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