Individual
BRAD W BRUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3331 W BERTEAU AVE APT 2A, CHICAGO, IL 60618-2346
(312) 218-0630
Mailing address
3331 W BERTEAU AVE APT 2A, CHICAGO, IL 60618-2346
(312) 218-0630
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.022866
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
IL
Other
Enumeration date
01/06/2026
Last updated
03/23/2026
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