Individual
BRADLEY PROCEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
421 W EXCHANGE ST, FREEPORT, IL 61032-4008
(815) 599-7300
Mailing address
PO BOX 813, FREEPORT, IL 61032-0813
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
208000221
IL
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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