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Contact Information

KIERRA L BRUNO RODGERS
712 N DEARBORN ST
CHICAGO, IL60654-3846
 Phone: 708-692-0728
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type
 

Sports Medicine

207XX0005X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for KIERRA L BRUNO RODGERS · (Female)

NPI # 1073080909
Status Active
Credentials
Entity Individual
Enumeration date 10/29/2018
Last updated 10/30/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 238000612
  • IL Other 238000612 REGISTERED SURGICAL ASSISTANT
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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