MEDICARE: KERNITA BREWSTER

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1588527345
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERNITA BREWSTER

Provider Business Mailing Address
First Line	:	1226 SPRUCE LN UNIT B
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60120-4823
Country	:	US
Telephone Number	:	224-391-4439
Fax Number	:

Provider Business Practice Location Address
First Line	:	1226 SPRUCE LN UNIT B
Second Line	:
City	:	ELGIN
State	:	IL
Zip	:	60120-4823
Country	:	US
Telephone Number	:	224-391-4439
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ KERNITA BREWSTER ” Practice Location

Language	Start Address	Practice Location

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