Healthcare Provider Details

I. General information

NPI: 1922489327
Provider Name (Legal Business Name): BRYAN PATRICK LAMB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26W171 ROOSEVELT RD
WHEATON IL
60187-6002
US

IV. Provider business mailing address

26W171 ROOSEVELT RD
WHEATON IL
60187-6002
US

V. Phone/Fax

Practice location:
  • Phone: 630-909-7000
  • Fax: 630-909-7002
Mailing address:
  • Phone: 630-909-7000
  • Fax: 630-909-7002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number68051
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number036.157985
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: