Individual
MR. JON BRUCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
333 N. LA GRANGE ROAD, VILLAGE MARKET,, LA GRANGE PARK, IL 60526-2539
(708) 745-5277
Mailing address
117 SAWYER AVE, LA GRANGE, IL 60525-2539
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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