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General NPI Number Information
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NPI Number | 1538689922
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Entity Type | Individual
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Provider Name | DAVID BROGAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2017
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 5145 N CALIFORNIA AVE
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City | CHICAGO
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State | IL
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Zip | 60625-3661
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Country | US
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Telephone | 773-989-3814
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Fax | 773-989-6230
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Provider Business Mailing Address
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Address Line | 2650 RIDGE AVE STE 1223
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City | EVANSTON
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State | IL
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Zip | 60201-1700
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036160427
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | LL40928
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License Number State | SC
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