Individual
BRYAN MICHAEL MISTRETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
701 N 1ST ST STE D327, SPRINGFIELD, IL 62702-3757
(217) 545-8444
(217) 545-7762
Mailing address
PO BOX 19638, SPRINGFIELD, IL 62794-9638
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
125076122
IL
208C00000X
Colon & Rectal Surgery Physician
Primary
036174964
IL
Other
Enumeration date
05/25/2020
Last updated
07/31/2025
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