Vassallo, Brett Joseph

Vassallo, Brett Joseph is an individual health care provider with primary practice located at 1875 Dempster St #665, Park Ridge IL 60068. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is his primary health care specialty. Vassallo, Brett Joseph can be contacted via phone (847) 825-1590.

Contact Information

Primary practice address
1875 Dempster St #665 Park Ridge IL 60068
Phone: (847) 825-1590
Fax: (847) 825-1604
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 036097455 Illinois
Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery 207VF0040X 036097455 Illinois

Profile Details

NPI number 1386654408
LBN Legal business name Vassallo, Brett Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Aug 8th, 2018 - about 7 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 1386654408 NPPES
Illinois MEDICAID 036097455

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