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General NPI Number Information
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NPI Number | 1073573143
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Entity Type | Individual
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Provider Name | ROBERT BRANNIGAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 06/23/2009
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Provider Practice Location Address
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Address Line | 675 N SAINT CLAIR ST GALTER 17-250
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City | CHICAGO
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State | IL
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Zip | 60611-5975
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Country | US
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Telephone | 312-695-5620
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Fax | 312-695-3999
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Provider Business Mailing Address
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Address Line | 680 N LAKE SHORE DR SUITE 1000
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City | CHICAGO
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State | IL
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Zip | 60611-4546
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Country | US
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Telephone | 312-695-5620
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Fax | 312-695-3999
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 036090931
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License Number State | IL
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