Individual
BRIAN NOCITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, PHARMD, MS
Contact information
Practice address
3880 SALEM LAKE DR STE F, LONG GROVE, IL 60047-5292
(847) 719-2220
(847) 719-2265
Mailing address
3880 SALEM LAKE DR STE F, LONG GROVE, IL 60047-5292
(847) 719-2220
(847) 719-2265
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036166827
IL
208M00000X
Hospitalist Physician
036166827
IL
390200000X
Student in an Organized Health Care Education/Training Program
125077693
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036166827
—
IL
01
—
FN3455258
DEA
IL
Enumeration date
05/07/2021
Last updated
06/12/2024
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