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Individual

DR. ANTHONY L BREITBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1117 EMERSON ST, EVANSTON, IL 60201-3131
(847) 869-1772
(847) 869-2733
Mailing address
1117 EMERSON ST, EVANSTON, IL 60201-3131
(847) 869-1772
(847) 869-2733

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38010236
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001634718
BCBS
IL
Enumeration date
11/06/2006
Last updated
11/10/2009
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