Individual
BRIAN A KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
6142 W ROOSEVELT RD, SUITE 105, OAK PARK, IL 60304
(708) 848-0021
(708) 848-0598
Mailing address
6142 W ROOSEVELT RD, SUITE 105, OAK PARK, IL 60304
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004091
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016004091
—
IL
Enumeration date
06/26/2006
Last updated
08/08/2022
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