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General NPI Number Information
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NPI Number | 1245908599
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Entity Type | Individual
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Provider Name | NATHAN E. BRIMM PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 09/01/2021
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 4646 N MARINE DR
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City | CHICAGO
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State | IL
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Zip | 60640-5759
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Country | US
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Telephone | 773-368-6781
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Fax |
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Provider Business Mailing Address
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Address Line | 2807 W ESTES AVE
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City | CHICAGO
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State | IL
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Zip | 60645-2903
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Country | US
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Telephone |
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.023943
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License Number State | IL
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