Provider Demographics
NPI:1932634003
Name:STOJAK, BRIAN JAMES (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:JAMES
Last Name:STOJAK
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 1:5346 N CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2120
Mailing Address - Country:US
Mailing Address - Phone:773-293-8880
Mailing Address - Fax:773-293-8843
Practice Address - Street 1:5346 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2120
Practice Address - Country:US
Practice Address - Phone:773-293-8880
Practice Address - Fax:773-293-8843
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-26
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036152245207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine