Individual
DR. BRIAN PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036089352
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036089352
—
IL
01
—
180029414
RAILROAD MEDICARE
—
Enumeration date
06/22/2005
Last updated
06/02/2025
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