Buckner, Brenna

Buckner, Brenna is an individual health care provider with primary practice located at 15 Commerce Dr Suite 111, Grayslake IL 60030-7807. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Buckner, Brenna can be contacted via phone (847) 548-3458.

Contact Information

Primary practice address
15 Commerce Dr Suite 111 Grayslake IL 60030-7807
Phone: (847) 548-3458
Fax: (847) 548-3459
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 056.011487 Illinois

Profile Details

NPI number 1639532492
LBN Legal business name Buckner, Brenna
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2016
Last updated Mar 30th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639532492 NPPES
Illinois Other 056.011487 STATE OF ILLINOIS

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