Braithwaite, Brian Michael

Braithwaite, Brian Michael is an individual health care provider with primary practice located at 601 W Randolph St , Chicago IL 60661-2232. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Braithwaite, Brian Michael can be contacted via phone (312) 258-9100.

Contact Information

Primary practice address
601 W Randolph St Chicago IL 60661-2232
Fax: (312) 258-1219
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery 2086S0122X 036096170 Illinois

Profile Details

NPI number 1518020072
LBN Legal business name Braithwaite, Brian Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 18th, 2006
Last updated Mar 19th, 2010 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1518020072 NPPES
Illinois MEDICAID 2702050216061101

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