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General NPI Number Information
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NPI Number | 1104976117
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Entity Type | Organization
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Legal Business Name | BONE HEALTH MANAGEMENT
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 720 OSTERMAN AVE #102
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City | DEERFIELD
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State | IL
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Zip | 60015-4471
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Country | US
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Telephone | 847-945-6552
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Fax | 847-945-6564
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Provider Business Mailing Address
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Address Line | 720 OSTERMAN AVE #102
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City | DEERFIELD
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State | IL
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Zip | 60015-4471
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Country | US
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Telephone | 847-945-6552
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Fax | 847-945-6564
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. MICHAEL THOMAS DIMUZIO
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Credential | PH.D.
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Telephone | 847-945-6552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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