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NPI Code Detail

MEDICARE: DR. RICHARD KARL BRYAN DC

MEDICARE:  DR. RICHARD KARL BRYAN  DC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NX0800XOrthopedic ChiropractorIL

General Provider Information

NPI Number : 1013929363
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD KARL BRYAN DC
Provider Business Mailing Address
First Line : 2105 N SOUTHPORT AVE
Second Line : SUITE #208
City : CHICAGO
State : IL
Zip : 60614-4069
Country : US
Telephone Number : 773-472-0560
Fax Number : 773-472-0429
Provider Business Practice Location Address
First Line : 2105 N SOUTHPORT AVE
Second Line : SUITE #208
City : CHICAGO
State : IL
Zip : 60614-4069
Country : US
Telephone Number : 773-472-0560
Fax Number : 773-472-0429
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 07/08/2007

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Directions to “ DR. RICHARD KARL BRYAN DC” Practice Location

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