Individual
DR. IVAN ROBERT BRACIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1720 GRAND AVE, WAUKEGAN, IL 60085-3502
(847) 625-0202
(847) 625-0101
Mailing address
1720 GRAND AVE, WAUKEGAN, IL 60085-3502
(847) 625-0202
(847) 625-0101
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
038007449
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04932043
BLUE CROSS BLUE SHIELD IL
IL
Enumeration date
01/04/2007
Last updated
08/08/2008
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