Provider Demographics
NPI:1619045200
Name:BRINSKELLE, PATRICIA A (AUD)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:A
Last Name:BRINSKELLE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:BRINSKELLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:5207 MAIN ST
Mailing Address - Street 2:STE5
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-4652
Mailing Address - Country:US
Mailing Address - Phone:630-981-0032
Mailing Address - Fax:630-241-0884
Practice Address - Street 1:5207 MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5071
Practice Address - Country:US
Practice Address - Phone:630-981-0032
Practice Address - Fax:630-241-0884
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1390231H00000X
IL147001337231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist