Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 036153281 | IL |
N | 2084N0400X | Neurologist | 036153281 | IL |
N | 2084V0102X | Vascular Neurology | 036153281 | IL |
NPI | 1033552088 |
---|---|
Provider Name | Dr. Brandon John Bond |
First Address | Maywood, IL 60153-3328 |
Second Address | Maywood, IL 60153-3328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2013 |
Last Update Date | 20/06/2021 |