Individual
EMILIE BRENNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3021 FALLING WATERS BLVD, LINDENHURST, IL 60046-6745
(847) 356-9300
Mailing address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3434-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100041810
—
WI
Enumeration date
08/20/2013
Last updated
11/29/2021
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