Individual
MR. ROBERT BRANNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
355 RIDGE AVE, EVANSTON, IL 60202-3328
(847) 316-3904
Mailing address
PO BOX 644, MINOOKA, IL 60447-0644
(815) 263-7779
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-006859
IL
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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