Individual
BRIANNA BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3104 N LEWIS AVE, WAUKEGAN, IL 60087-2231
(847) 599-1185
Mailing address
3104 N LEWIS AVE, WAUKEGAN, IL 60087-2231
(847) 599-1185
(847) 599-1275
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-011859
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/18/2024
Last updated
02/09/2026
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