Braithwaite, Brian Michael
Braithwaite, Brian Michael is an individual health care provider with primary practice located at 601 W Randolph St , Chicago IL 60661-2232. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, which is considered as his primary health care specialty. Braithwaite, Brian Michael can be contacted via phone (312) 258-9100.Contact Information
Primary practice address
601 W Randolph St
Chicago IL 60661-2232
Phone: (312) 258-9100
Fax: (312) 258-1219
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | 036096170 | Illinois |
Profile Details
| NPI number | 1518020072 |
|---|---|
| LBN Legal business name | Braithwaite, Brian Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 18th, 2006 |
| Last updated | Mar 19th, 2010 - about 15 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 | 1518020072 | NPPES |
| Illinois | MEDICAID | 2702050216061101 |
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