Brandon Alexander Escobedo
Pediatrics, Developmental - Behavioral Pediatrics in Montgomery, IL. Individual provider (NPI-1).
NPI number1710728126
StatusActive
Last updated in NPPESJun 3, 2024
Details
- NPI
- 1710728126
- Entity type
- Individual (NPI-1)
- Name
- Brandon Alexander Escobedo
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 3, 2024
- Certification date
- Jun 2, 2024
- Last updated
- Jun 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080P0006X | Pediatrics, Developmental - Behavioral Pediatrics | E213-0610-4043 | IL | Yes |
Practice location
2523 Deer Point DrMontgomery, IL 60538-4052
Phone 630-796-9084
Mailing address
2523 Deer Point DrMontgomery, IL 60538-4052
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