Individual
BRIAN PATRICK OLOFSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 N WALL, SUITE 510, KANKAKEE, IL 60901
(815) 932-5725
(815) 932-5872
Mailing address
400 N WALL, SUITE 510, KANKAKEE, IL 60901
(815) 932-5725
(815) 932-5872
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036067325
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036067325
—
IL
Enumeration date
09/27/2006
Last updated
12/04/2014
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