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General NPI Number Information
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NPI Number | 1134186497
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Entity Type | Individual
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Provider Name | DAVID M BROTTMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 3325 N ARLINGTON HEIGHTS RD SUITE 100A
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-1582
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Country | US
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Telephone | 847-398-0400
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Fax | 847-398-9590
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Provider Business Mailing Address
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Address Line | 3325 N ARLINGTON HEIGHTS RD SUITE 100A
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-1582
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Country | US
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Telephone | 847-398-0400
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Fax | 847-398-9590
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036079960
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License Number State | IL
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