IndividualActive
Brett Staib, NAVY IDC
NPI 1972793909 · Independent Duty Corpsman · Great Lakes, IL
Provider details
- NPI number
- 1972793909
- Entity type
- Individual
- Primary specialty
- Independent Duty CorpsmanOther Service Providers
- Credential
- NAVY IDC
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
3420 Illinois St
Bhc 1007
Great Lakes, IL 60088-3120
Phone: (847) 688-7536
Approximate (ZIP-level) locationGet directions
Mailing address
3420 Illinois Street
Great Lakes, IL 60088-5230
Registry dates
- Enumerated
- 2007-07-26
- Last updated
- 2007-07-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.