Individual
BROGAN REPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
34159 N HAINESVILLE RD, ROUND LAKE, IL 60073-9790
(847) 722-0063
Mailing address
34159 N HAINESVILLE RD, ROUND LAKE, IL 60073-9790
(847) 722-0063
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041413004
IL
363L00000X
Nurse Practitioner
Primary
209027936
IL
Other
Enumeration date
02/06/2023
Last updated
01/05/2024
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