Provider Demographics
NPI:1699009126
Name:BRUTZKUS, JOSEPH C (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:BRUTZKUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOEY
Other - Middle Name:
Other - Last Name:BRUTZKUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1001 COMMERCE DR STE 605
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-8865
Mailing Address - Country:US
Mailing Address - Phone:630-225-2263
Mailing Address - Fax:331-732-4591
Practice Address - Street 1:1001 COMMERCE DR STE 605
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-8865
Practice Address - Country:US
Practice Address - Phone:630-225-2263
Practice Address - Fax:331-732-4591
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036164517207XX0005X, 2081S0010X
IL036.164517208100000X
IL125073778208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty