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Individual
BRAD A. STOECKER
Active
Individual
BRAD A. STOECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-116395
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116395
—
IL
01
—
809840
MEDICARE GROUP #
IL
01
—
833230
GROUP # FOR PONTIAC
—
01
—
CA2182
RR MEDICARE GROUP PTAN (PONTIAC)
IL
01
—
CA4079
RR MEDICARE GROUP #
—
01
—
P00406153
RR MEDICARE IND. #
—
01
—
P00601872
RR MEDICARE IND PTAN (PONTIAC)
IL
Enumeration date
07/22/2006
Last updated
07/25/2008
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