MEDICARE: DR. ARTHUR J BRECK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	036063050	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427098870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTHUR J BRECK MD

Provider Business Mailing Address
First Line	:	PO BOX 1567
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61110-0067
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 W BLACKHAWK DR
Second Line	:
City	:	BYRON
State	:	IL
Zip	:	61010-8988
Country	:	US
Telephone Number	:	779-696-1300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	02/05/2015

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