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Individual

BRYAN S TRAUBERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2800 N SHERIDAN RD, #103, CHICAGO, IL 60657
(773) 575-8700
(773) 525-8699
Mailing address
2800 N SHERIDAN RD, #103, CHICAGO, IL 60657
(773) 575-8700
(773) 525-8699

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
363843619
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001618089
BC
01
034270001
DME
05
036066257
IL
Enumeration date
11/20/2006
Last updated
07/14/2010
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