Individual
DR. ROBERT A. BRAASTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1302 FRANKLIN AVE, SUITE 4500, NORMAL, IL 61761-3551
(309) 556-8293
Mailing address
611 W. PARK ST, FAPC, URBANA, IL 61801-3551
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036-091224
IL
207RC0000X
Cardiovascular Disease Physician
22973
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017331
HEEALTH ALLIANCE
IL
05
—
036091224
—
IL
01
—
05732097
BC GROUP NUMBER
IL
Enumeration date
04/20/2006
Last updated
05/02/2022
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