Brink, Dale Steven

Brink, Dale Steven is an individual health care provider with primary practice located at 401 E 162Nd St Ste 101 , South Holland IL 60473-2237. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Brink, Dale Steven can be contacted via phone (708) 596-3757.

Contact Information

Primary practice address
401 E 162Nd St Ste 101 South Holland IL 60473-2237
Phone: (708) 596-3757
Fax: (708) 596-3779
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016-004747 Illinois

Profile Details

NPI number 1093722365
LBN Legal business name Brink, Dale Steven
Credentials DPM, FACFAS
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Dec 2nd, 2009 - about 16 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 1093722365 NPPES
Illinois MEDICAID 016004747

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