Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | IL |
NPI | 1073550109 |
---|---|
Provider Name | Dr. Richard A Brash |
First Address | Elmhurst, IL 60126-5626 |
Second Address | Elmhurst, IL 60126-5626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 08/07/2007 |