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General NPI Number Information
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NPI Number | 1730396318
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Entity Type | Organization
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Legal Business Name | A.M. & M.D. BROHNER D.P.M., INC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5318 W DEVON AVE
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City | CHICAGO
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State | IL
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Zip | 60646-4108
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Country | US
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Telephone | 773-792-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 5318 W DEVON AVE
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City | CHICAGO
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State | IL
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Zip | 60646-4108
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Country | US
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Telephone | 773-792-9300
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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. MARTIN D. BROHNER
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Credential | D.P.M.
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Telephone | 773-792-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State | IL
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