Provider Demographics
NPI:1891236295
Name:BURWASH-BRENNAN, TALIA REGINA RUTH (MD)
Entity Type:Individual
Prefix:
First Name:TALIA
Middle Name:REGINA RUTH
Last Name:BURWASH-BRENNAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 MCLEOD STREET
Mailing Address - Street 2:APT 608
Mailing Address - City:OTTAWA
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:K2P1A3
Mailing Address - Country:CA
Mailing Address - Phone:1613-804-2705
Mailing Address - Fax:
Practice Address - Street 1:1901 WEST HARRISON STREET
Practice Address - Street 2:DEPARTMENT OF TRAUMA, JOHN H. STROGER HOSPITAL OF COOK
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-864-0390
Practice Address - Fax:312-864-9919
Is Sole Proprietor?:No
Enumeration Date:2017-03-17
Last Update Date:2017-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program