King, Brian A
King, Brian A is an sole proprietor health care provider with primary practice located at 6142 W Roosevelt Rd Suite 105, Oak Park IL 60304. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. King, Brian A can be contacted via phone (708) 848-0021.Contact Information
Primary practice address
6142 W Roosevelt Rd Suite 105
Oak Park IL 60304
Phone: (708) 848-0021
Fax: (708) 848-0598
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 016004091 | Illinois |
Profile Details
| NPI number | 1962439091 |
|---|---|
| LBN Legal business name | King, Brian A |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 26th, 2006 |
| Last updated | Aug 8th, 2022 - about 2 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 | 1962439091 | NPPES |
| Illinois | MEDICAID | 016004091 |
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