Individual
DR. BRIAN DANIEL BOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
303 E CHICAGO AVE, WARD6-204, CHICAGO, IL 60611-4296
(312) 503-8144
Mailing address
303 E CHICAGO AVE, WARD6-204, CHICAGO, IL 60611-4296
(312) 503-8144
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
125-049094
IL
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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