MEDICARE: BRANDIE REMKE

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1720427214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDIE REMKE

Provider Business Mailing Address
First Line	:	1256 WATERFORD DR
Second Line	:	SUITE 140
City	:	AURORA
State	:	IL
Zip	:	60504-4510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1256 WATERFORD DR
Second Line	:	SUITE 140
City	:	AURORA
State	:	IL
Zip	:	60504-4510
Country	:	US
Telephone Number	:	630-898-5322
Fax Number	:	630-898-5324

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

Provider Enumeration Date	:	06/18/2013
Last Update Date	:	06/18/2013

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Directions to “ BRANDIE REMKE ” Practice Location

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