Individual
SANDRA BRUDENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5910 W DIVISION ST, CHICAGO, IL 60651-1031
(773) 777-7112
Mailing address
1803 S CALIFORNIA AVE, CHICAGO, IL 60608-2482
(847) 721-9654
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/23/2015
Last updated
12/23/2015
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