Healthcare Provider Details

I. General information

NPI: 1952880536
Provider Name (Legal Business Name): ERIN M BRUCE APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3633 W LAKE AVE STE 409
GLENVIEW IL
60026-5804
US

IV. Provider business mailing address

3633 W LAKE AVE STE 409
GLENVIEW IL
60026-5804
US

V. Phone/Fax

Practice location:
  • Phone: 847-834-4361
  • Fax: 847-834-9217
Mailing address:
  • Phone: 847-834-4361
  • Fax: 847-834-9217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209017576
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number377.003236
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277.003415
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: