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Contact Information

BROCK B MULLENBACH, DO
6712 N CONVENT ST
BOURBONNAIS, IL60914-1528
 Phone: 815-605-8403
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
 

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for BROCK B MULLENBACH · (Male)

NPI Number 1841750924
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 03/23/2019
Last updated 07/09/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IL License # 036.164439
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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