Barry A Brandes, D.P.M.
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Oak Forest, IL
NPI 1073663217 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1073663217
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- 016-002988-1 (IL)
- Practice address
- 15900 S. Cicero Ave.
Department of Surgery
Oak Forest, IL 60452 - Phone
- (708) 633-2874
- Fax
- (170) 863-3418
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016-002988-1 | IL | MD | Foot & Ankle Surgery Podiatrist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 016-002988-1 | IL | Yes |
Addresses
Primary practice location
15900 S. Cicero Ave.
Department of Surgery
Oak Forest, IL 60452
Mailing address
15900 S. Cicero Ave.
Department of Surgery
Oak Forest, IL 60452
Phone (708) 633-2874
Other providers in Oak Forest, IL
- Jennifer Alice Boender
- Brumentha Bony
- Isabella Monika Borzecki
- Malcolm K Brachman Jr.
- Bradley Therapy and Wellness
- Sarah Jean Brandt
- Bremen Youth Services
- Gina Breuer
- Anita Jo Brown
- Norman Brown
All providers in Oak Forest, IL · Foot & Ankle Surgery Podiatrist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.