Individual
DR. TODD R BRACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2233 W DIVISION ST, CHICAGO, IL 60622-3043
(312) 770-2181
(312) 770-3159
Mailing address
2233 W DIVISION ST, CHICAGO, IL 60622-3043
(312) 770-2181
(312) 770-3159
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036093203
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093203
—
IL
Enumeration date
05/11/2006
Last updated
08/02/2007
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