DR. TODD R BRACK (NPI# 1669422630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669422630 |
| Entity Type | Individual |
| Full Name | DR. TODD R BRACK |
| Credential | D.O. |
| Practice Address |
2233 W Division St Chicago IL 60622-3043 |
| Practice Telephone | 3127702181 |
| Practice Fax Number | 3127703159 |
| Mailing Telephone | 3127702181 |
| Mailing Fax Number | 3127703159 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2007-08-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
036093203 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036093203 | 05 |
| Street Address |
2233 W DIVISION ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60622-3043 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801895263 | Maruti Bhorade, M.d. | Internal Medicine | 2233 W Division St, Chicago, IL 60622-3043 | 2005-07-19 |
| 1750909396 | Savannah Leigh Paul | Registered Nurse | 2233 W Division St, Chicago, IL 60622-8151 | 2020-07-09 |
| 1700413648 | Julian Carr Aliber | Physical Therapist | 2233 W Division St, Chicago, IL 60622-8151 | 2020-03-23 |
| 1598391674 | Vanessa Patkowski | Occupational Therapist | 2233 W Division St, Chicago, IL 60622-8151 | 2020-03-20 |
| 1013551472 | Work & Pillay Sc | Psychiatry & Neurology | 2233 W Division St, Chicago, IL 60622-8151 | 2019-10-29 |
| 1861043085 | Andrea Beshalske | Pharmacist | 2233 W Division St, Chicago, IL 60622-8151 | 2019-09-28 |
| 1982269379 | Jessica M Kunkel | Nurse Anesthetist, Certified Registered | 2233 W Division St, Chicago, IL 60622-8151 | 2019-05-01 |
| 1427514280 | Megan Hynes | Registered Nurse | 2233 W Division St, Chicago, IL 60622-8151 | 2019-02-18 |
| 1548724982 | Joel Manalo Ocampo | Nurse Practitioner | 2233 W Division St, Chicago, IL 60622-8151 | 2019-01-30 |
| 1104390301 | Adriel Geoff Cansino | Registered Nurse | 2233 W Division St, Chicago, IL 60622-8151 | 2019-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447880471 | Erikson Institute | Clinic/Center | 2739 W Division St, Chicago, IL 60622 | 2020-01-17 |
| 1720620545 | Emily Claire Bonanno | Counselor | 1397 N Miwaukee Ave, Chicago, IL 60622 | 2019-10-14 |
| 1891342093 | Taylor Mallon | Speech-Language Pathologist | 8870 South Duffy Avenue, Apartment 406, Chicago, IL 60622 | 2019-08-22 |
| 1083260277 | Maggie Inman | Student in an Organized Health Care Education/Training Program | 1431 N Claremont Avenue, 2nd Floor Pavilion, Chicago, IL 60622 | 2019-08-13 |
| 1174176168 | Karol Maricel Quelal Analuisa | Internal Medicine | 1901 W Harrison, Chicago Il 60612-3714, Chicago, IL 60622 | 2019-07-19 |
| 1073076105 | Nichole Galullo | Social Worker | 1431 N Claremont 2nd Floor, Chicago, IL 60622 | 2019-04-06 |
| 1003375122 | Alfredo Delgado Perez Sr. | Psychologist | 1127 N Oakley Bvl 3 Floor, Chicago, IL 60622 | 2019-03-18 |
| 1841773439 | Abigail Hector | Counselor | 1521 N Milwaukee Ave, 3n, Chicago, IL 60622 | 2018-09-11 |
| 1164916144 | Dorothy Mitkowski | Student in an Organized Health Care Education/Training Program | 1127 N. Oakley Blvd., 2nd Floor, Chicago, IL 60622 | 2018-06-21 |
| 1255825121 | Kara Lynn Daniel | Speech-Language Pathologist | 1540 N Artesian Ave Apt 2r, Chicago, IL 60622 | 2018-06-14 |
| Find all providers in zip 60622 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376196220 | Parvathamma Imaging Services, LLC | Radiology | 7431 S East End Ave Ste 2, Chicago, IL 60649-3611 | 2019-07-19 |
| 1225516842 | Tyler Jonathan Hinkel | Radiology | 33 W Ontario St Apt 46f, Chicago, IL 60654 | 2018-08-06 |
| 1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
| 1790132934 | Peter Barton Moreau | Radiology | 1740 W Taylor St Rm 2483, Chicago, IL 60612-7232 | 2016-05-18 |
| 1043678899 | Burce Ozgen Mocan | Radiology | 1740 W Taylor St Rm 2511, Department of Radiology (mc931), Chicago, IL 60612-7232 | 2016-02-08 |
| 1538552898 | Imo Ime Uko | Radiology | 4646 N Marine Dr Ste 7100, Chicago, IL 60640 | 2015-03-11 |
| 1962891739 | Katherine Conlon | Radiology | 240 E Huron St # 1-203, Chicago, IL 60611 | 2015-01-16 |
| 1861805871 | Arun Nagaraju | Radiology | 5841 S. Maryland Ave. Suite Mc2026, University of Chicago, Chicago, IL 60637-1448 | 2014-06-06 |
| 1568873529 | Emily Ghobadi | Radiology | 250 E Superior St Rm 4-2304, Chicago, IL 60611-2914 | 2014-05-13 |
| 1306266903 | Jessica Kristen Peterson | Radiology | 250 E Superior St Ste 4-2304, Chicago, IL 60611-2914 | 2014-04-22 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.