Individual
DR. DOUGLAS H BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 LAKE AVE, WOODSTOCK, IL 60098-7401
(815) 337-7100
(815) 337-4793
Mailing address
2000 LAKE AVE, WOODSTOCK, IL 60098-7401
(815) 337-7100
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036-114015
IL
208600000X
Surgery Physician
48880
WI
2086S0129X
Vascular Surgery Physician
Primary
036-114015
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036114015 1
—
IL
05
—
34696800
—
WI
Enumeration date
08/29/2006
Last updated
03/26/2025
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