King, Brian A

King, Brian A is an sole proprietor health care provider with primary practice located at 6142 W Roosevelt Rd Suite 105, Oak Park IL 60304. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. King, Brian A can be contacted via phone (708) 848-0021.

Contact Information

Primary practice address
6142 W Roosevelt Rd Suite 105 Oak Park IL 60304
Phone: (708) 848-0021
Fax: (708) 848-0598
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016004091 Illinois

Profile Details

NPI number 1962439091
LBN Legal business name King, Brian A
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 26th, 2006
Last updated Aug 8th, 2022 - 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 1962439091 NPPES
Illinois MEDICAID 016004091

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