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Individual

DR. BRENT BREWER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
2320 N DAMEN AVE, SUITE 1R, CHICAGO, IL 60647-3359
(773) 489-0001
(773) 489-0003
Mailing address
2800 N TALMAN AVE, UNIT F, CHICAGO, IL 60618-7898
(630) 430-8147
(773) 478-7047

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038009882
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01636659
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/14/2007
Last updated
07/08/2007
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