DR. BREANNE GREMILLION (NPI# 1568073104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568073104 |
| Entity Type | Individual |
| Full Name | DR. BREANNE GREMILLION |
| Credential | PSYD |
| Practice Address |
11800 S 75th Ave Ste 101 Palos Heights IL 60463-1062 |
| Mailing Address |
2015 S Finley Rd Apt 407 Lombard IL 60148-4850 |
| Practice Telephone | 7086718440 |
| Mailing Telephone | 7083100246 |
| Enumeration Date | 2020-08-16 |
| Last Update Date | 2020-08-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
071010332 | IL | Behavioral Health & Social Service Providers |
| Street Address |
11800 S 75TH AVE STE 101 |
| City | PALOS HEIGHTS |
| State | IL |
| Zip Code | 60463-1062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932756095 | Kim Rusiecki | Technician | 25 Parliament Drive East, Palos Heights, IL 60463 | 2019-08-23 |
| 1265925218 | Sentinel Anesthesia of Illinois, PC | Anesthesiology | 7340 W College Dr Fl 1, Palos Heights, IL 60463 | 2018-06-13 |
| 1225410848 | Deborah Ann Castaneda | Skilled Nursing Facility | 12350 Natchez Ave., Palos Heights, IL 60463 | 2015-06-19 |
| 1609253160 | Tareq Ayyad | Physical Therapy Assistant | 11730 Lighthouse Ln, Palos Heights, IL 60463 | 2015-05-04 |
| 1366846503 | Ryan Teahen | Dentist | 7600 W College Dr Ste 17, Palos Heights, IL 60463 | 2014-10-17 |
| 1295140309 | Paul Park | Ophthalmology | 7600 W College Dr Ste 9, Palos Heights, IL 60463 | 2014-06-26 |
| 1275976045 | Nazim A. Khan | Physician Assistant | 6450 West College Drive, Palos Heights, IL 60463 | 2013-04-11 |
| 1619246824 | Amanda M Ejka | Psychologist | 11800 South 75th Avenue, Suite 300, Palos Heights, IL 60463 | 2011-12-16 |
| 1578832937 | Sandi Maheras | Pharmacist | 1703 Spyglass Cir, Palos Heights, IL 60463 | 2011-12-14 |
| 1043597065 | Ashraf Olwan | Pharmacist | 7660 W Sequoia Rd, Palos Heights, IL 60463 | 2011-11-04 |
| Find all providers in zip 60463 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851943062 | Patrick Thomas Kaulen Jr. | Psychologist | 11800 S 75th Ave Ste 3, Palos Heights, IL 60463-1033 | 2019-07-09 |
| 1730619578 | Anna Jasiewicz | Psychologist | 11800 S 75th Ave Ste 300, Palos Heights, IL 60463-1064 | 2017-06-14 |
| 1750654596 | Ian E Hoffman | Psychologist | 11800 S 75th Ave Fl 3, Palos Heights, IL 60463-1033 | 2012-02-09 |
| 1902964695 | Leading Change PC | Psychologist | 7250 College Drive, Suite 1w, Palos Heights, IL 60463 | 2006-12-05 |
| 1326067331 | Susan Marie Radtke | Psychologist | 11952 South Harlem Ave, Suite 200 B, Palos Heights, IL 60463-1167 | 2006-07-19 |
| 1093755241 | Jessica Joan Loftus | Psychologist | 7110 W 127th St Ste 150, Palos Heights, IL 60463-1579 | 2006-06-07 |
| 1033197025 | Dr Laura A Beaumont | Psychologist | 11801 Southwest Highway, Ste 3 South, Palos Heights, IL 60463 | 2006-01-09 |
| 1225670243 | Elizabeth Polek | Psychologist | 11800 S 75th Ave Ste 300, Palos Heights, IL 60463-1064 | 2019-10-10 |
| 1679059497 | Neel Mehta | Psychologist | 11800 S 75th Ave Fl 3, Palos Heights, IL 60463-1033 | 2018-07-15 |
| 1043712433 | Elizabeth Nicole Smith | Psychologist | 11800 S 75th Ave Ste 300, Palos Heights, IL 60463-1064 | 2018-03-01 |
| Find all providers in PALOS HEIGHTS | ||||
| City | PALOS HEIGHTS |
| Zip Code | 60463 |
Please comment or provide details below to improve the information on DR. BREANNE GREMILLION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.