Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 38009979 | IL |
NPI | 1427267020 |
---|---|
Provider Name | Dr. Daniel Jason Brotschul |
First Address | Frankfort, IL 60423-1279 |
Second Address | Frankfort, IL 60423-1279 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |