Ehlie Bruno, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

021002890 Issued in IL

Practice address

5342 S Archer Ave
Chicago, IL 60632-4949

Phone

(773) 284-1645

NPI assigned

Jun 11, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• American Dental Associates LTD

  • Dentist
  • Chicago, IL
  • NPI 1134391139
  NPD (past)
• Louis N Korompilas DDS PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Orland Park, IL
  • NPI 1609947498
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1417219056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 N MILWAUKEE AVE STE 406",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302389",
            "telephone_number": "414-510-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5342 S ARCHER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324949",
            "telephone_number": "773-284-1645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3736 W 26th St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606233826",
            "country_code": "US",
            "telephone_number": "708-637-0505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1812 N 19th Ave",
            "address_purpose": "LOCATION",
            "city": "Melrose Park",
            "state": "IL",
            "postal_code": "601602039",
            "country_code": "US",
            "telephone_number": "708-779-7099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUNO",
        "first_name": "EHLIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "021002890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Brunning
• Bruno Knopp DDS,LTD
• Kierra La Shawn Bruno-Rodgers
• Caroline Regan Bruno, NP
• Claire Bruno, RD
• Michelle Barbara Bruno, AGACNP
• Denise Brunozzi
• Debra Lynn Bruns, OT
• Jordan Elizabeth Bruns, OTR/L
• Katy Marie O'Hanlon Bruns

• Oral and Maxillofacial Surgery (Dentist) in Chicago, IL
• Providers in Chicago, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.