Mary C Bruell is a Clinical in Peoria, Illinois. Mary C Bruell practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary C Bruell is 1659345007. The last update date is 2009-11-25.
Mary C Bruell's current location address is 1 Illini Dr, Peoria, Illinois. You can contact this provider via phone number 3096718503. The mailing address for Mary C Bruell is 1 Illini Dr, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary C Bruell |
|---|---|
| Address | 1 Illini Dr, Peoria, Illinois |
| Phone Number | 3096718503 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1659345007 |
|---|---|
| Provider Enumeration Date | 2006-02-14 |
| Last Updated Date | 2009-11-25 |
Provider Mailing Address Detail
| Address | 1 Illini Dr |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616052576 |
| Phone Number | 3096718503 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 149008927 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7215036 | IL | BCBS |
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What is the unique 10-digit identifier code issued to Mary C Bruell by the Centers for Medicare & Medicaid Services?
The Mary C Bruell has been assigned the NPI (National Provider Identifier) 1659345007 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Mary C Bruell?
The Mary C Bruell is physically situated at 1 Illini Dr, in the city of Peoria, state of IL, with the postal code 616052576.
What is Mary C Bruell's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Mary C Bruell's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 1041C0700X.
On what date did the Mary C Bruell receive its 1659345007 assignment from the Centers for Medicare & Medicaid Services?
The Mary C Bruell was assigned its 1659345007 by the Centers for Medicare & Medicaid Services on 2006-02-14.
As of what date were the details related to Mary C Bruell most recently updated or revised?
The information pertaining to Mary C Bruell, including its address, specialty, and other relevant details, was last updated or revised on 2009-11-25.