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NPI Code Detail

MEDICARE: MRS. LINDA A BRUGGEMANN LPC

MEDICARE: MRS. LINDA A BRUGGEMANN LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorIL

General Provider Information

NPI Number : 1740499938
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDA A BRUGGEMANN LPC
Provider Business Mailing Address
First Line : 2645 W GREENLEAF AVE
Second Line : APT. 3W
City : CHICAGO
State : IL
Zip : 60645-3264
Country : US
Telephone Number : 773-274-8075
Fax Number : 773-388-5088
Provider Business Practice Location Address
First Line : 5547 N RAVENSWOOD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60640-1125
Country : US
Telephone Number : 773-506-3201
Fax Number : 773-769-1476
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2007
Last Update Date : 07/08/2007

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