Provider Demographics
NPI:1467405472
Name:BRANDIES, JULIE R (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:R
Last Name:BRANDIES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 VOLLMER RD
Mailing Address - Street 2:11TH FLOOR
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-3168
Mailing Address - Country:US
Mailing Address - Phone:708-481-8883
Mailing Address - Fax:
Practice Address - Street 1:4001 VOLLMER RD
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-3168
Practice Address - Country:US
Practice Address - Phone:708-481-8883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2021-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-092935207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-092935Medicaid
G30173Medicare UPIN