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Individual

KATHY M VANBRUNT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
15 S OLD RAND RD, LAKE ZURICH, IL 60047-2313
(847) 438-2144
(847) 438-1597
Mailing address
15 S OLD RAND RD, LAKE ZURICH, IL 60047-2313

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0850003752
IL

Other

Enumeration date
09/01/2005
Last updated
07/08/2007
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