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NPI Code Detail

MEDICARE: MRS. CASSANDRA LYNN BROOKS FNP

MEDICARE: MRS. CASSANDRA LYNN BROOKS FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse041348622IL
2363LF0000XFamily Nurse Practitioner209014415IL

General Provider Information

NPI Number : 1134674989
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CASSANDRA LYNN BROOKS FNP
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-1293
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 1 UNIVERSITY PKWY
Second Line :
City : UNIVERSITY PARK
State : IL
Zip : 60484-3165
Country : US
Telephone Number : 708-235-2120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2016
Last Update Date : 05/17/2022

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