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NPI Code Detail

MEDICARE: BRONWYN RUTH BERAN M.S.

MEDICARE:   BRONWYN RUTH BERAN  M.S.
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
1235Z00000XSpeech-Language Pathologist146010889IL

General Provider Information

NPI Number : 1912253873
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRONWYN RUTH BERAN M.S.
Provider Business Mailing Address
First Line : 1160 S MICHIGAN AVE
Second Line : UNIT 1005
City : CHICAGO
State : IL
Zip : 60605-2776
Country : US
Telephone Number : 608-921-9398
Fax Number :
Provider Business Practice Location Address
First Line : 1160 S MICHIGAN AVE
Second Line : UNIT 1005
City : CHICAGO
State : IL
Zip : 60605-2776
Country : US
Telephone Number : 608-921-9398
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2012
Last Update Date : 07/30/2012

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Directions to “ BRONWYN RUTH BERAN M.S.” Practice Location

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