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1063076354
FUNCTIONAL FIRST
EVANSTON, IL
NPI
1063076354
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Entity Type
Organization
Authorized Contact
DEBRA BRUNK
Owner/Nurse Practitioner
847-624-0959
Organization Subpart ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
Enumeration Date
2019-04-23
Last Update Date
2019-04-23
Business Address
FUNCTIONAL FIRST
1818 DEMPSTER ST
EVANSTON, IL 60202-1003
Phone number: 847-624-0959
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Mailing Address
FUNCTIONAL FIRST
429 W ALDINE AVE
CHICAGO, IL 60657-3992
Phone number: 847-624-0959
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