Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 036120505 | IL |
NPI | 1003997875 |
---|---|
Provider Name | Dr. Darren Michael Brenner |
First Address | Chicago, IL 60611-5975 |
Second Address | Chicago, IL 60611-5975 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 26/06/2008 |