Michelle Brunner Los

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.012593 Issued in IL

Practice address

505 W Maple St
Hinsdale, IL 60521-3109

Phone

(847) 997-1028

NPI assigned

Nov 13, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Michelle Theresa Brunner Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Legacy Healthcare Services Inc

  • Physical Therapist
  • Grayslake, IL
  • NPI 1689141376

  Multi-Specialty

  Medicare reassignment NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1437794559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 N MARSHFIELD AVE # 3N",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225129",
            "telephone_number": "847-997-1028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 W MAPLE ST",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213109",
            "telephone_number": "847-997-1028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOS",
        "first_name": "MICHELLE",
        "middle_name": "BRUNNER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.012593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "146.012593",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Chicago",
            "affiliation": "N",
            "endpointDescription": "for work use",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "814 N Marshfield Ave # 3N",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606225129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "BRUNNER",
            "middle_name": "THERESA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William E Long, D.O.
• Roland E. Lonser, M.D.
• Lorah Inc (ActiveRx Chicago Clinic)
• Mark A. Lorenz, M.D.
• John A Los, DDS
• June R. Losurdo, A.P.N.-C.N.P.
• Tracy Anne Loudon, M.D.
• Steven Louis
• James R. Lovelace, D.D.S.
• Lucy Ibrahim

• Speech-Language Pathologist in Hinsdale, IL
• Providers in Hinsdale, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.