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General NPI Number Information
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NPI Number | 1396814380
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Entity Type | Organization
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Legal Business Name | AIMEE C. BRUECK INC.
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1908 N MOHAWK ST UNIT 22
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City | CHICAGO
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State | IL
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Zip | 60614-5220
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Country | US
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Telephone | 773-677-3758
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Fax |
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Provider Business Mailing Address
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Address Line | 1908 N MOHAWK ST UNIT 22
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City | CHICAGO
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State | IL
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Zip | 60614-5220
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Country | US
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Telephone | 773-677-3758
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. AIMEE C. BRUECK
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Credential |
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Telephone | 773-677-3758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | IL
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