Individual
JERRY BRASEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
5510 W LINCOLN HWY, (US ROUTE 30), SCHERERVILLE, IN 46375-1020
(219) 865-1436
Mailing address
625 ENTERPRISE DR, OAK BROOK, IL 60523-8813
(630) 575-1916
(630) 928-5016
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056-002245
IL
225X00000X
Occupational Therapist
Primary
31001355A
IN
Other
Enumeration date
08/04/2011
Last updated
04/20/2017
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