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General NPI Number Information
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NPI Number | 1497731293
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Entity Type | Individual
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Provider Name | THOMAS A RUNNE DPM
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Gender | Male
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 1437 S BELL SCHOOL RD STE 2
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City | ROCKFORD
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State | IL
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Zip | 61108-1405
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Country | US
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Telephone | 815-260-7731
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Fax | 630-897-6851
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Provider Business Mailing Address
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Address Line | 1955 W DOWNER PL
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City | AURORA
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State | IL
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Zip | 60506-4384
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Country | US
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Telephone | 815-260-7731
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Fax | 630-897-6849
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 016004049
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License Number State | IL
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