| Brian A. King | |
|
6142 Roosevelt Rd Suite 105 Oak Park IL 60304-2311 | |
| (708) 848-0021 | |
| (708) 848-0598 |
| Full Name | Brian A. King |
|---|---|
| Speciality | Clinic/center |
| Location | 6142 Roosevelt Rd, Oak Park, Illinois |
| Authorized Official Name and Position | Brian a King (PODIATRIST) |
| Authorized Official Contact | 7088480021 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian A. King 6142 W Roosevelt Road Suite 105 Oak Park IL 60304 Ph: (708) 848-0021 | Brian A. King 6142 Roosevelt Rd Suite 105 Oak Park IL 60304-2311 Ph: (708) 848-0021 |
| NPI Number | 1639344781 |
|---|---|
| Provider Enumeration Date | 04/29/2008 |
| Last Update Date | 05/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639344781 | NPI | - | NPPES |
| 016004091 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (NU) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (NU) | Secondary |
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