Brackett, Demitrius

Brackett, Demitrius is an sole proprietor health care provider with primary practice located at 311 N Ottawa St Apt 209 , Joliet IL 60432-4080. He recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Pain, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Brackett, Demitrius can be contacted via phone (815) 766-5999.

Contact Information

Primary practice address
311 N Ottawa St Apt 209 Joliet IL 60432-4080
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Pain 261QP3300X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 91079 Illinois

Profile Details

NPI number 1053911479
LBN Legal business name Brackett, Demitrius
Credentials OWNER/DO
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 26th, 2020
Last updated Aug 3rd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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