Brandt, Timothy David
Brandt, Timothy David is an sole proprietor health care provider with primary practice located at 7906 S Parkside , Burbank IL 60459. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Brandt, Timothy David can be contacted via phone (708) 636-1173.Contact Information
Primary practice address
7906 S Parkside
Burbank IL 60459
Phone: (708) 636-1173
Fax: (708) 636-1017
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 3535252 | Illinois |
Profile Details
| NPI number | 1265532428 |
|---|---|
| LBN Legal business name | Brandt, Timothy David |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 25th, 2006 |
| Last updated | Nov 18th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265532428 | NPPES |
| Illinois | MEDICAID | 036053252 | |
| Illinois | Other | 793111512 |
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