MEDICARE: DR. CHRISTINE Z. PUNDY M.D.

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	207W00000X	Ophthalmology Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1633328	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1831110733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE Z. PUNDY M.D.

Provider Business Mailing Address
First Line	:	1588 N ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3906
Country	:	US
Telephone Number	:	847-392-9220
Fax Number	:	847-392-9252

Provider Business Practice Location Address
First Line	:	1588 N ARLINGTON HEIGHTS RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-3906
Country	:	US
Telephone Number	:	847-392-9220
Fax Number	:	847-392-9252

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

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	03/11/2008

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