Brian Powell Valid NPI
Individual provider · General Practice Physician · Maywood, IL
- NPI
- 1225422330
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Physician (General Practice)
- Specialty group
- Allopathic & Osteopathic Physicians
- Taxonomy code
- 208D00000X
- License number
- 036146884 (IL)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2015-03-26
- Last updated
- 2019-05-30
Practice location
2160 S 1st Ave
Maywood, IL 60153-3328
(708) 327-3436