Provider Demographics
NPI:1790967263
Name:DR. BRIAN JAMES FRENCH
Entity Type:Organization
Organization Name:DR. BRIAN JAMES FRENCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:773-585-8200
Mailing Address - Street 1:8620 S PULASKI RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-3633
Mailing Address - Country:US
Mailing Address - Phone:773-585-8200
Mailing Address - Fax:773-585-8004
Practice Address - Street 1:8620 S PULASKI RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-3633
Practice Address - Country:US
Practice Address - Phone:773-585-8200
Practice Address - Fax:773-585-8004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0859430001Medicare NSC
IL744140Medicare PIN