Healthcare Provider Details

I. General information

NPI: 1285378877
Provider Name (Legal Business Name): BRYAN MAKOWSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 E OGDEN AVE STE 101
HINSDALE IL
60521-3892
US

IV. Provider business mailing address

23W281 CAMBRIDGE CT
GLEN ELLYN IL
60137-6501
US

V. Phone/Fax

Practice location:
  • Phone: 708-434-4090
  • Fax: 708-948-7847
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036.177933
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: