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General NPI Number Information
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NPI Number | 1033199336
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Entity Type | Individual
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Provider Name | ANDREW B PUNDY MD
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Gender | Male
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 03/04/2022
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Provider Practice Location Address
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Address Line | 1875 DEMPSTER SUITE 490
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City | PARK RIDGE
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State | IL
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Zip | 60068-1120
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Country | US
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Telephone | 847-518-8490
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Fax | 847-518-8492
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Provider Business Mailing Address
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Address Line | 1875 DEMPSTER ST STE 504
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City | PARK RIDGE
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State | IL
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Zip | 60068-1130
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Country | US
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Telephone | 847-518-8490
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Fax | 847-518-8492
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036053081
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License Number State | IL
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