| Doctor Name: | MICHELLE BRUNETTI |
| NPI Number: | 1154380608 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | 209005311 |
| Business Practice Address: | 161 Washington St Suite 1400 Conshohocken, PA - 194282083 |
| Business Phone Number: | 4843513800 |
| Business Fax Number: | |
| Mailing Address: | 8747 W Bryn Mawr Ave, #206 CHICAGO |
| State: | IL |
| Postal Code: | 606313683 |
| Phone Number: | 7734440451 |
| Fax Number: | |
| NPI Enumeration Date: | 03/22/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 209005311 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |