Provider Demographics
NPI:1952817561
Name:BRUER, YOSEF BILAL (OTD, OTR/L, RBT)
Entity Type:Individual
Prefix:DR
First Name:YOSEF
Middle Name:BILAL
Last Name:BRUER
Suffix:
Gender:M
Credentials:OTD, OTR/L, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650-1133
Mailing Address - Country:US
Mailing Address - Phone:217-243-6451
Mailing Address - Fax:
Practice Address - Street 1:5295 WATERMAN BLVD APT B42
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1186
Practice Address - Country:US
Practice Address - Phone:540-761-9173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-19
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056015810225X00000X
MO2023016977225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist