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NPI Code Detail

MEDICARE: DR. PATRICIA A BROSSARD D.C.

MEDICARE: DR. PATRICIA A BROSSARD D.C.
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
1111N00000XChiropractor038-005836IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10024949396OTHERILBCBS PROVIDER #

General Provider Information

NPI Number : 1750487526
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PATRICIA A BROSSARD D.C.
Provider Business Mailing Address
First Line : 3907 FARMINGTON LN
Second Line :
City : JOHNSBURG
State : IL
Zip : 60051-5175
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 110 S WYNSTONE PARK DR
Second Line : SUITE 105
City : N BARRINGTON
State : IL
Zip : 60010-6979
Country : US
Telephone Number : 847-540-6060
Fax Number : 847-277-8012
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2006
Last Update Date : 06/18/2012

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Directions to “ DR. PATRICIA A BROSSARD D.C.” Practice Location

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