Individual
NICHOLAS QUINN BRUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
601 E ROOSEVELT RD, LOMBARD, IL 60148-4740
(630) 206-5574
Mailing address
779 W ADAMS ST, CHICAGO, IL 60661-3509
(830) 734-6667
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085011281
IL
Other
Enumeration date
03/08/2025
Last updated
07/31/2025
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