Most Relevant Information
Provider Data
| NPI Number: | 1003394024 |
| Provider Name: | MARY PATRICIA BRANDENBURG CRNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 1-121617 |
Most Important Dates
| Enumeration Date: | 08/01/2018 |
| Last Updated: | 09/20/2022 |
Provider Practice Location
355 E ERIE ST
CHICAGO
IL
606113167
Practice Location Phone/Fax
| Phone: | 3122381000 |
| Fax: | 3122383695 |
Provider Mailing Location
355 E ERIE ST
CHICAGO
IL
606113167
Provider Mailing Phone/Fax
| Phone: | 3122381000 |
| Fax: |