Healthcare Provider Details

I. General information

NPI: 1669528626
Provider Name (Legal Business Name): KAREN L. BRUNEEL D.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 N LINCOLN AVE SUITE 6
CHICAGO IL
60625-2092
US

IV. Provider business mailing address

5713 W WARWICK AVE
CHICAGO IL
60634-2658
US

V. Phone/Fax

Practice location:
  • Phone: 773-769-1133
  • Fax:
Mailing address:
  • Phone: 773-427-8634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: