Patresa R Brager is a Clinical in Peoria, Illinois. Patresa R Brager practices all healthcare services and medical treatments related to Clinical. The NPI Number for Patresa R Brager is 1043236573. The last update date is 2007-07-08.
Patresa R Brager's current location address is 515 Ne Glen Oak Ave, Peoria, Illinois. You can contact this provider via phone number 3096556724 and fax number 3096554408. The mailing address for Patresa R Brager is 515 Ne Glen Oak Ave, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Patresa R Brager |
|---|---|
| Address | 515 Ne Glen Oak Ave, Peoria, Illinois |
| Phone Number | 3096556724 |
| Fax Number | 3096554408 |
| Sole Proprietor | N |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1043236573 |
|---|---|
| Provider Enumeration Date | 2006-07-15 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 515 Ne Glen Oak Ave |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616370001 |
| Phone Number | 3096556724 |
| Fax Number | 3096554408 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 207414 | MEDICARE GROUP NO. |
Post Comment/ Review Below
What is the unique identifier code issued to Patresa R Brager by the Centers for Medicare & Medicaid Services (CMS)?
The Patresa R Brager has been assigned the NPI (National Provider Identifier) 1043236573. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete physical address where Patresa R Brager is located?
The Patresa R Brager is situated at the following address: 515 Ne Glen Oak Ave, Peoria, IL, 616370001.
What is Patresa R Brager's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Patresa R Brager is Clinical, and the taxonomy code that categorizes this field of expertise is 103Tc0700X.
When was the Patresa R Brager's 1043236573 issued?
The Patresa R Brager's 1043236573 was issued on 2006-07-15.
As of what date were the details pertaining to Patresa R Brager last refreshed?
The information related to the Patresa R Brager, including its address, specialty, and other relevant details, was last updated on 2007-07-08.