Individual
BRYAN FILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
25 NORTH WINFIELD ROAD, CDH-FLR 4-NORTH TOWER, WINFIELD, IL 60190-1295
(630) 933-4267
Mailing address
25 NORTH WINFIELD ROAD, CDH-FLR 4-NORTH TOWER, WINFIELD, IL 60190-1295
(630) 933-4267
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041375998
IL
363LF0000X
Family Nurse Practitioner
Primary
277000896
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206147
MEDICARE PTAN GROUP
IL
01
—
F400228277
MEDICARE PTAN INDIVIDUAL
IL
Enumeration date
07/18/2014
Last updated
08/07/2025
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