Dodt, Bruce I

Dodt, Bruce I is an individual health care provider with primary practice located at 500 N Wall St Ste 300 , Kankakee IL 60901-2942. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Dodt, Bruce I can be contacted via phone (815) 935-0750.

Contact Information

Primary practice address
500 N Wall St Ste 300 Kankakee IL 60901-2942
Fax: (815) 935-8797
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 036060250 Illinois

Profile Details

NPI number 1013059005
LBN Legal business name Dodt, Bruce I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2007
Last updated Mar 22nd, 2021 - about 4 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 1013059005 NPPES
Illinois MEDICAID 036060250

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