MEDICARE: A.M. & M.D. BROHNER D.P.M., INC

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	213E00000X	Podiatrist		IL

General Provider Information

NPI Number	:	1730396318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A.M. & M.D. BROHNER D.P.M., INC

Provider Business Mailing Address
First Line	:	5318 W DEVON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-4108
Country	:	US
Telephone Number	:	773-792-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	5318 W DEVON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-4108
Country	:	US
Telephone Number	:	773-792-9300
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARTIN D. BROHNER
Credential	:	D.P.M.
Telephone Number	:	773-792-9300

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	08/22/2020

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