Individual
BRODIE MACKINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 N 4TH ST, SPRINGFIELD, IL 62702-5238
(217) 545-8000
Mailing address
520 N 4TH ST, SPRINGFIELD, IL 62702-5238
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125085849
IL
Other
Enumeration date
07/10/2025
Last updated
07/10/2025
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