Provider Demographics
NPI:1912964313
Name:BRECHER, ALLAN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:MICHAEL
Last Name:BRECHER
Suffix:
Gender:M
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:PO BOX 64568
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85082-4568
Mailing Address - Country:US
Mailing Address - Phone:630-288-6200
Mailing Address - Fax:855-781-4084
Practice Address - Street 1:3231 EUCLID AVE STE 409
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3472
Practice Address - Country:US
Practice Address - Phone:708-788-2201
Practice Address - Fax:708-405-2047
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036088577207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036088577Medicaid
IL036088577Medicaid