Individual
BRAD PARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 N 1ST ST, SPRINGFIELD, IL 62702-3749
(217) 528-7541
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036-116654
IL
208C00000X
Colon & Rectal Surgery Physician
Primary
036116654
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116654
—
IL
Enumeration date
05/01/2007
Last updated
05/21/2020
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