Bruce I Dodt
Neurologist
500 N Wall St Ste 300
Kankakee
, Illinois 60901-2942
Bruce I Dodt
Neurologist
500 N Wall St Ste 300
Kankakee
, Illinois 60901-2942
(815) 935-8797
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About
Features
Specialties
- Neurologist
Languages spoken
- English
Location
First Address
- Bruce I Dodt
- 500 N Wall St Ste 300
- Kankakee, IL
- Zip : 60901-2942
- Fax : (815) 935-8797
- Phone : (815) 935-0750
Second Address
- Bruce I Dodt
- 500 N Wall St Ste 300
- Kankakee, IL
- Zip : 60901-2942
- Fax : (815) 935-8797
- Phone : (815) 935-0750
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2084N0400X | Neurologist | 036060250 | IL |
National Provider Identifier
| NPI | 1013059005 |
|---|---|
| Provider Name | Bruce I Dodt |
| First Address | Kankakee, IL 60901-2942 |
| Second Address | Kankakee, IL 60901-2942 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/02/2007 |
| Last Update Date | 22/03/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036060250 | (05) | IL |
| C45958 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.