Provider Demographics
NPI:1447367149
Name:SPUNAR, HENRY VAL (DPM)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:VAL
Last Name:SPUNAR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6780 N NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1201
Mailing Address - Country:US
Mailing Address - Phone:773-763-4788
Mailing Address - Fax:773-763-4174
Practice Address - Street 1:6780 N NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-1201
Practice Address - Country:US
Practice Address - Phone:773-763-4788
Practice Address - Fax:773-763-4174
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016-002920213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL522050Medicare ID - Type Unspecified
ILT36954Medicare UPIN