Provider Demographics
NPI:1942256813
Name:BRENNAN, JULEE (OT)
Entity Type:Individual
Prefix:
First Name:JULEE
Middle Name:
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 RAND RD STE 300
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2359
Mailing Address - Country:US
Mailing Address - Phone:847-324-3976
Mailing Address - Fax:847-929-1154
Practice Address - Street 1:9000 WAUKEGAN RD STE 100
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-2128
Practice Address - Country:US
Practice Address - Phone:847-779-6050
Practice Address - Fax:847-929-1167
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-002014225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK 23822Medicare UPIN
ILK31816Medicare PIN
ILK31817Medicare PIN