Individual
LINDA BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, (RUSSO ENT., RM. 1016), MAYWOOD, IL 60153
(708) 216-8563
(708) 216-2275
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
(858) 249-6749
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
36072594
IL
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
Primary
36072594
IL
Other
Enumeration date
02/15/2006
Last updated
01/06/2017
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