| Doctor Name: | MATHEW BRUNO |
| NPI Number: | 1104854066 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | |
| Business Practice Address: | 150 W High St Morris, IL - 604501463 |
| Business Phone Number: | 8159422932 |
| Business Fax Number: | |
| Mailing Address: | Po Box 66973, Slot 303125 CHICAGO |
| State: | IL |
| Postal Code: | 606660973 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/29/2006 |
| NPI Last Update Date: | 07/12/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |