Individual
AMANDA M BRAMHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1029 E 130TH ST, CHICAGO, IL 60628-6908
(773) 995-6300
Mailing address
1005 HEALTH CENTER DR STE 201, MATTOON, IL 61938-4693
(217) 238-6055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-133693
IL
207Q00000X
Family Medicine Physician
101592
WI
207Q00000X
Family Medicine Physician
83732-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689994014
—
IL
05
—
1689994014
—
WI
Enumeration date
06/08/2010
Last updated
05/01/2025
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