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General NPI Number Information
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NPI Number | 1821197583
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Entity Type | Individual
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Provider Name | KAREN BRAUTIGAM
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 8741 S GREENWOOD AVE
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City | CHICAGO
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State | IL
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Zip | 60619-7061
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Country | US
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Telephone | 630-521-3132
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Fax |
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Provider Business Mailing Address
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Address Line | 12120 CONWAY RD
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8213
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Country | US
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Telephone | 314-251-4833
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Fax | 314-251-8712
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 074654
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209024770
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License Number State | IL
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