Individual
BRYAN ANOCHILI IKEUDENTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(608) 756-6000
Mailing address
7702 N ALPINE RD, LOVES PARK, IL 61111-3107
(346) 779-9821
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125078130
IL
207Q00000X
Family Medicine Physician
79475
MN
208M00000X
Hospitalist Physician
83666-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2021
Last updated
09/04/2025
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