OrganizationBurr Ridge Family Practice , Ltd.Family MedicineAllopathic & Osteopathic PhysiciansPractice Address11 Salt Creek Ln Ste 125, Hinsdale, IL 60521-2902(630) 655-1177PECOS EnrollmentBased on the most recent information from CMS, provider Burr Ridge Family Practice , Ltd. does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1790891877Provider TypeOrganizationFull NameBurr Ridge Family Practice , Ltd.SubpartNoEnumeration Date8/22/2006Last Updated4/20/2008Contact InformationPractice LocationPractice Address11 Salt Creek Ln Ste 125, Hinsdale, IL 60521-2902Phone(630) 655-1177FaxUnlisted FaxMailing LocationMailing Address11 Salt Creek Ln Ste 125, Hinsdale, IL 60521-2902Phone(630) 655-1177FaxUnlisted FaxAuthorized OfficialNameCiungan, Porfira (Arspecialist)Phone(847) 735-9330Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID2232216DescriptionOtherIssuerBC/BS OF IL PROVIDER #Illinois