Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BROCK B MULLENBACH, D.O.
ActiveDR. BROCK B MULLENBACH, D.O. is a Sports Medicine (PM&R) healthcare provider located in BOURBONNAIS, Illinois. NPI 1841750924 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (PM&R) · BOURBONNAIS, IL
Registration Details
- NPI Number
- 1841750924
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 23, 2019 (7.4348918459354 yrs)
- Last Updated
- Jul 9, 2024
- Licenses
-
036.164439 (IL)036.164439 (IL)
Practice Information
- Address
-
6712 N CONVENT STBOURBONNAIS, IL, 609141528Browse IL providers · Browse ZIP 60914
- Phone
- 8156058403
- Primary Specialty
-
Sports Medicine (PM&R)
2081S0010X
- Additional Specialty
- Sports Medicine (PM&R)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.