Healthcare Provider Details

I. General information

NPI: 1841437696
Provider Name (Legal Business Name): JANE A BRAUN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2009
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20635 ABBEY WOODS CT N STE 303
FRANKFORT IL
60423-3191
US

IV. Provider business mailing address

8417 CRESTWOOD AVE
MUNSTER IN
46321-2011
US

V. Phone/Fax

Practice location:
  • Phone: 708-372-7286
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JANE BRAUN
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PH.D.
Phone: 708-372-7286