MEDICARE: ROBERT J BRUNO MDPC

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	207Q00000X	Family Medicine Physician	036060840	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205060142
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT J BRUNO MDPC

Provider Business Mailing Address
First Line	:	4550 SOUTHWEST HWY
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-1842
Country	:	US
Telephone Number	:	708-499-5140
Fax Number	:	708-499-5155

Provider Business Practice Location Address
First Line	:	4550 SOUTHWEST HWY
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-1842
Country	:	US
Telephone Number	:	708-499-5140
Fax Number	:	708-499-5155

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT J. BRUNO
Credential	:	M.D.
Telephone Number	:	708-499-5140

Provider Enumeration Date	:	05/06/2009
Last Update Date	:	05/13/2009

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