Individual
MICHAEL J CONRAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 N HIGHLAND AVE, AURORA, IL 60506-1404
(630) 859-8700
Mailing address
1870 W GALENA BLVD, AURORA, IL 60506-4356
(630) 859-6700
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
35055629
OH
208800000X
Urology Physician
Primary
036066056
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036066056
—
IL
01
—
04515143
BCBS#
IL
Enumeration date
11/22/2006
Last updated
07/27/2011
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