Shortal, Brian Patrick

Shortal, Brian Patrick is an individual health care provider with primary practice located at 2151 Waukegan Rd Suite 100, Bannockburn IL 60015-1885. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Shortal, Brian Patrick can be contacted via phone (847) 444-5328.

Contact Information

Primary practice address
2151 Waukegan Rd Suite 100 Bannockburn IL 60015-1885
Phone: (847) 444-5328
Fax: (847) 267-0694
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036-111585 Illinois

Profile Details

NPI number 1356331961
LBN Legal business name Shortal, Brian Patrick
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2005
Last updated Feb 8th, 2021 - about 3 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 1356331961 NPPES
Illinois Other 04915267 BLUE CROSS BLUE SHIELD
Illinois MEDICAID 36111585 BLUE CROSS BLUE SHIELD

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