MEDICARE: BRIANNA WARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program		IL

General Provider Information

NPI Number	:	1326908146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA WARD

Provider Business Mailing Address
First Line	:	1256 AMANDA CIR
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60123-8906
Country	:	US
Telephone Number	:	708-973-7891
Fax Number	:

Provider Business Practice Location Address
First Line	:	16000 VAN DRUNEN RD STE 8
Second Line	:
City	:	SOUTH HOLLAND
State	:	IL
Zip	:	60473-1242
Country	:	US
Telephone Number	:	708-637-6760
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2025
Last Update Date	:	11/13/2025

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Directions to “ BRIANNA WARD ” Practice Location

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