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NPI Code Detail

MEDICARE: EMILY BRUMLEY DPT

MEDICARE: EMILY BRUMLEY DPT
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
1225100000XPhysical Therapist070025400IL

General Provider Information

NPI Number : 1841892783
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY BRUMLEY DPT
Provider Business Mailing Address
First Line : 203 N HOME AVE
Second Line :
City : PARK RIDGE
State : IL
Zip : 60068-3029
Country : US
Telephone Number : 630-673-3383
Fax Number :
Provider Business Practice Location Address
First Line : 2316 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60614-7760
Country : US
Telephone Number : 312-739-3030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2020
Last Update Date : 11/16/2020

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