Healthcare Provider Details

I. General information

NPI: 1073191987
Provider Name (Legal Business Name): BRACEMAN CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 BRACKEN PARKWAY 190BP
HOBART IN
46342
US

IV. Provider business mailing address

190 BRACKEN PARKWAY 190BP
HOBART IN
46342
US

V. Phone/Fax

Practice location:
  • Phone: 847-736-6686
  • Fax: 773-940-1943
Mailing address:
  • Phone: 847-736-6686
  • Fax: 773-940-1943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: SEEMA SHEIKH
Title or Position: PRESIDENT
Credential: CPO
Phone: 773-940-1933