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General NPI Number Information
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NPI Number | 1033096029
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Entity Type | Organization
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Legal Business Name | ASCEND SPINE & REHAB LLC
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 3833 E MAIN ST
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City | ST CHARLES
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State | IL
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Zip | 60174-2424
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Country | US
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Telephone | 630-779-8658
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Fax |
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Provider Business Mailing Address
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Address Line | 3S266 BRIARWOOD DR
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City | WARRENVILLE
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State | IL
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Zip | 60555-2623
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Country | US
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Telephone | 630-779-8658
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | SHANE BRUNI
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Credential | DC
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Telephone | 630-779-8658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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