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NPI Code Detail

MEDICARE: AUTUMN BRUSH

MEDICARE: AUTUMN BRUSH
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
1106H00000XMarriage & Family Therapist

General Provider Information

NPI Number : 1679219000
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUTUMN BRUSH
Provider Business Mailing Address
First Line : 70 S RIVER ST
Second Line :
City : AURORA
State : IL
Zip : 60506-5185
Country : US
Telephone Number : 630-844-2662
Fax Number : 630-844-3084
Provider Business Practice Location Address
First Line : 70 S RIVER ST
Second Line :
City : AURORA
State : IL
Zip : 60506-5185
Country : US
Telephone Number : 630-844-2662
Fax Number : 630-844-3084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2022
Last Update Date : 03/09/2026

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Directions to “ AUTUMN BRUSH ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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