Individual
DEBRA LEA BULICEK BRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
310 S MAIN ST STE D, LOMBARD, IL 60148-2692
(630) 652-0200
Mailing address
310 S MAIN ST STE D, LOMBARD, IL 60148-2692
(630) 652-0200
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146013640
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146013640
ILLINOIS
IL
Enumeration date
08/15/2018
Last updated
08/15/2018
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