Healthcare Provider Details

I. General information

NPI: 1891801338
Provider Name (Legal Business Name): MICHAEL BRETT SILBERBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 HAWAII ST
EL SEGUNDO CA
90245-4814
US

IV. Provider business mailing address

4320 WINFIELD RD SUITE 200
WARRENVILLE IL
60555-4018
US

V. Phone/Fax

Practice location:
  • Phone: 253-680-8062
  • Fax:
Mailing address:
  • Phone: 630-836-8724
  • Fax: 866-594-9002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberG75934
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: