Moline, Bryan G
Moline, Bryan G is an individual health care provider with primary practice located at 610 S Maple Ave Suite 2100, Oak Park IL 60304-1091. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Moline, Bryan G can be contacted via phone (708) 660-2240.Contact Information
Primary practice address
610 S Maple Ave Suite 2100
Oak Park IL 60304-1091
Phone: (708) 660-2240
Fax: (708) 660-2243
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036074841 | Illinois |
Profile Details
| NPI number | 1720046774 |
|---|---|
| LBN Legal business name | Moline, Bryan G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2006 |
| Last updated | Aug 22nd, 2011 - 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 | 1720046774 | NPPES |
| Illinois | MEDICAID | 036074841 |
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