Individual
MRS. KATY MARIE O'HANLON BRUNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1802 W BERTEAU AVE STE 205, CHICAGO, IL 60613-6182
(708) 568-1557
Mailing address
1802 W BERTEAU AVE STE 205, CHICAGO, IL 60613-6182
(708) 568-1557
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649518515
NPI
IL
Enumeration date
08/19/2022
Last updated
09/21/2023
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