Bryan, George T

Bryan, George T is an individual health care provider with primary practice located at 5666 East State Street , Rockford IL 61108-2472. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Bryan, George T can be contacted via phone (815) 226-2000.

Contact Information

Primary practice address
5666 East State Street Rockford IL 61108-2472
Phone: (815) 226-2000
Fax: (815) 227-2658
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X Illinois

Profile Details

NPI number 1447287495
LBN Legal business name Bryan, George T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2006
Last updated Feb 14th, 2008 - about 17 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 1447287495 NPPES
Illinois MEDICAID 36090851

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