Individual
JEFFREY W BRANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 W 162ND ST, SOUTH HOLLAND, IL 60473-2003
(708) 730-2200
(708) 210-0648
Mailing address
100 W 162ND ST, SOUTH HOLLAND, IL 60473-2003
(708) 730-2200
(708) 210-0648
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036134540
IL
Other
Enumeration date
05/27/2010
Last updated
12/16/2021
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