Provider Demographics
NPI:1629673942
Name:BR PSYCHIATRY PLLC
Entity Type:Organization
Organization Name:BR PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAO
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSNELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-608-6346
Mailing Address - Street 1:100 E 14TH ST APT 2501
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3674
Mailing Address - Country:US
Mailing Address - Phone:312-608-6356
Mailing Address - Fax:312-608-6346
Practice Address - Street 1:2900 N LAKE SHORE DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5640
Practice Address - Country:US
Practice Address - Phone:847-493-3521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-03
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty