Brandt, Mark T

Brandt, Mark T is an individual health care provider with primary practice located at 350 S Northwest Hwy Ste 106 , Park Ridge IL 60068-4262. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Brandt, Mark T can be contacted via phone (847) 470-1500.

Contact Information

Primary practice address
350 S Northwest Hwy Ste 106 Park Ridge IL 60068-4262
Phone: (847) 470-1500
Fax: (847) 470-1550
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 036084697 Illinois

Profile Details

NPI number 1942248794
LBN Legal business name Brandt, Mark T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2006
Last updated Dec 8th, 2021 - about 3 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 1942248794 NPPES
Illinois Other P00268096 RAILROAD MEDICARE
Illinois MEDICAID 036084697 RAILROAD MEDICARE

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