Individual
MRS. DONNETTE ANITRA BRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1306 GEMINI CIR, SUITE 3, OTTAWA, IL 61350-1694
(815) 431-9980
(815) 431-9981
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-013097
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00915429
MEDICARE RAILROAD
IL
Enumeration date
03/19/2007
Last updated
05/27/2011
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