Individual
MATTHEW BRUNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
925 WEST ST, PERU, IL 61354-2757
(815) 221-1384
Mailing address
925 WEST ST, PERU, IL 61354-2757
(815) 221-1384
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085001822
IL
363AM0700X
Medical Physician Assistant
Primary
085001822
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00035862
RAILROAD MEDICARE
IL
Enumeration date
06/29/2006
Last updated
07/31/2026
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