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General NPI Number Information
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NPI Number | 1326223579
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Entity Type | Organization
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Legal Business Name | JB ORTHOPEDIC CONSULTING, SC
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 666 DUNDEE RD SUITE 1001
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City | NORTHBROOK
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State | IL
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Zip | 60062-2727
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Country | US
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Telephone | 847-480-7580
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Fax | 847-227-3250
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Provider Business Mailing Address
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Address Line | 1187 WILMETTE AVE #213
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City | WILMETTE
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State | IL
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Zip | 60091-2719
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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 | PRESIDENT
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Name | DR. JOHN ANDREW BRNA
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Credential | M.D.
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Telephone | 847-480-7580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 042.619179036.064599
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License Number State | IL
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