Proctor, Brian

Proctor, Brian is an individual health care provider with primary practice located at 675 W North Ave Ste 107, Melrose Park IL 60160-1622. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Proctor, Brian can be contacted via phone (708) 450-4510.

Contact Information

Primary practice address
675 W North Ave Ste 107 Melrose Park IL 60160-1622
Phone: (708) 450-4510
Fax: (708) 450-9361
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036089352 Illinois

Profile Details

NPI number 1649276833
LBN Legal business name Proctor, Brian
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2005
Last updated Jun 22nd, 2020 - 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 1649276833 NPPES
Other 180029414 RAILROAD MEDICARE
MEDICAID 036089352 RAILROAD MEDICARE

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