Organization
FUNCTIONAL FIRST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA BRUNK APRN (OWNER/NURSE PRACTITIONER)
(847) 624-0959
Entity
Organization
Contact information
Practice address
1818 DEMPSTER ST, EVANSTON, IL 60202-1003
(847) 624-0959
Mailing address
429 W ALDINE AVE, CHICAGO, IL 60657-3992
(847) 624-0959
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/23/2019
Last updated
04/23/2019
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