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Individual

DEBRA BRUNK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
1501 S. CALIFORNIA AVE., CHICAGO, IL 60608
(773) 257-6770
Mailing address
1501 S. CALIFORNIA AVE., CHICAGO, IL 60608
(773) 257-6770

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209-004016
IL
363LF0000X
Family Nurse Practitioner
Primary
209-004016
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
209-004016
APN LICENSE#
IL
Enumeration date
10/03/2006
Last updated
05/13/2015
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