Individual
AMBER D BRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17860 BAKER AVE, COUNTRY CLUB HILLS, IL 60478-4729
(708) 476-1884
(708) 960-4513
Mailing address
17860 BAKER AVE, COUNTRY CLUB HILLS, IL 60478-4729
(708) 476-1884
(708) 960-4513
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070011553
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01535359
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/02/2007
Last updated
07/08/2007
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