Individual
DR. BRIAN PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
675 W NORTH AVE, STE 107, MELROSE PARK, IL 60160-1622
(708) 450-4510
(708) 450-9361
Mailing address
675 W NORTH AVE, STE 107, MELROSE PARK, IL 60160-1622
(708) 450-4510
(708) 450-9361
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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