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General NPI Number Information
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NPI Number | 1053439448
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Entity Type | Organization
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Legal Business Name | BRIKHA MEDICAL CENTER SC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 8118 N MILWAUKEE AVE SUITE # 105
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City | NILES
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State | IL
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Zip | 60714-2836
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Country | US
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Telephone | 847-692-5206
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Fax | 847-692-5394
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Provider Business Mailing Address
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Address Line | 8118 N MILWAUKEE AVE SUITE # 105
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City | NILES
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State | IL
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Zip | 60714-2836
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Country | US
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Telephone | 847-692-5206
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Fax | 847-692-5394
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHARLES S BRIKHA
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Credential | MD
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Telephone | 847-692-5206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036097975
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License Number State | IL
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