Individual
DR. EDWARD BOONE BRACKETT III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1125 WESTGATE ST, OAK PARK, IL 60301-1007
(708) 848-7700
(708) 848-9375
Mailing address
1125 WESTGATE ST, OAK PARK, IL 60301-1007
(708) 848-7700
(708) 848-9375
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
36-37881
IL
Other
Enumeration date
11/03/2006
Last updated
07/08/2007
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