Individual
DR. BENJAMIN GULBRAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-3311
Mailing address
611 W PARK ST, URBANA, IL 61801-2529
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
125.071396
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125.071396
TEMPORARY MEDICAL PERMIT
IL
Enumeration date
06/27/2017
Last updated
04/12/2023
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