Provider Demographics
NPI:1720210875
Name:BRUSZER, MICHELLE JANETTE (AUD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:JANETTE
Last Name:BRUSZER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:215 SHUMAN BLVD
Mailing Address - Street 2:STE 401
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8458
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:978-313-6824
Practice Address - Street 1:111 N WABASH AVE
Practice Address - Street 2:STE 1618
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-3049
Practice Address - Country:US
Practice Address - Phone:312-251-0100
Practice Address - Fax:312-251-0123
Is Sole Proprietor?:No
Enumeration Date:2009-08-21
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147.001444231H00000X
CAAU2755231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist