Provider Demographics
NPI:1912325812
Name:BRAUN, JASON
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:BRAUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SHUMAN BLVD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8123
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:978-313-6824
Practice Address - Street 1:8751 N 51ST AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-4941
Practice Address - Country:US
Practice Address - Phone:623-915-5568
Practice Address - Fax:623-915-5641
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHAD4944237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist