Individual
DEBRA LYNN BRUNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2142 W BELLE PLAINE AVE, CHICAGO, IL 60618-3004
(312) 493-1148
Mailing address
PO BOX 57217, CHICAGO, IL 60657-0217
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633156
BCBS PROVIDER NUMBER
IL
01
—
7112565
AETNA PROVIDER NUMBER
—
Enumeration date
12/05/2006
Last updated
07/08/2007
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