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NPI Code Detail

MEDICARE: DR. JOSEPH WALTER PUNDY MD

MEDICARE: DR. JOSEPH WALTER PUNDY MD
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
1207R00000XInternal Medicine PhysicianIL

General Provider Information

NPI Number : 1639110745
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH WALTER PUNDY MD
Provider Business Mailing Address
First Line : 4849 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-2503
Country : US
Telephone Number : 773-622-0769
Fax Number : 773-728-8719
Provider Business Practice Location Address
First Line : 4849 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-2503
Country : US
Telephone Number : 773-622-0769
Fax Number : 773-728-8719
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 03/07/2023

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Directions to “ DR. JOSEPH WALTER PUNDY MD” Practice Location

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