Individual
EDEN D BRANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10718 S EWING AVE, CHICAGO, IL 60617
(773) 731-5456
(773) 731-5456
Mailing address
10718 S EWING AVE, CHICAGO, IL 60617
(773) 731-5456
(773) 731-5456
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036095540
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00445820
MEDICARE RAILROAD
IL
Enumeration date
08/24/2007
Last updated
05/02/2008
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