Provider Demographics
NPI:1043365265
Name:BRUNEGRAFF, CLAIRE STAFFORD (PHD)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:STAFFORD
Last Name:BRUNEGRAFF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 LEHIGH AVE STE 215
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1692
Mailing Address - Country:US
Mailing Address - Phone:847-425-6400
Mailing Address - Fax:
Practice Address - Street 1:2300 LEHIGH AVE STE 215
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-1692
Practice Address - Country:US
Practice Address - Phone:847-425-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071002727103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral