Provider Demographics
NPI:1134490485
Name:BRUNO, THOMAS RALPH (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:RALPH
Last Name:BRUNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1881 PRESTWICK DR
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:IL
Mailing Address - Zip Code:60067-4650
Mailing Address - Country:US
Mailing Address - Phone:847-991-0980
Mailing Address - Fax:847-991-0980
Practice Address - Street 1:1881 PRESTWICK DR
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:IL
Practice Address - Zip Code:60067-4650
Practice Address - Country:US
Practice Address - Phone:847-991-0980
Practice Address - Fax:847-991-0980
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036039865207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery