MEDICARE: BROOKE MARIE WILSON DMD

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
1	122300000X	Dentist	019.034343	IL

General Provider Information

NPI Number	:	1477230522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE MARIE WILSON DMD

Provider Business Mailing Address
First Line	:	8841 BUTTERFIELD LN
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-1440
Country	:	US
Telephone Number	:	773-837-1110
Fax Number	:

Provider Business Practice Location Address
First Line	:	12130 S HARLEM AVE STE B
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1459
Country	:	US
Telephone Number	:	708-728-3300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2023
Last Update Date	:	06/30/2023

Similar Medicare Providers

1750564951 — MIRIAM DEFAY PT
Practice Location Address:

5 CEDAR HEIGHTS EST
DUNCANSVILLE, PA
16635-1459

Practice Phone: 814-693-9243
Practice Fax:

1912710245 — CARLEATHA LEWIS
Practice Location Address:

1044 WOODVIEW RD
CLEVELAND HEIGHTS, OH
44121-1459

Practice Phone: 216-804-3215
Practice Fax:

1982140018 — JALESSIA LYRAY GREEN PA-C
Practice Location Address:

12251 S 80TH AVE STE 1520
PALOS HEIGHTS, IL
60463-1290

Practice Phone: 708-923-4200
Practice Fax: 708-923-4201

1891354593 — DR. NEIL JOSEPH MIER MD
Practice Location Address:

12251 S 80TH AVE
PALOS HEIGHTS, IL
60463-1290

Practice Phone: 708-923-4000
Practice Fax: 708-923-5859

1881155760 — DR. YOSRY N MEZYED MD
Practice Location Address:

12251 S 80TH AVE
PALOS HEIGHTS, IL
60463-1290

Practice Phone: 708-923-4000
Practice Fax: 708-923-5859

1114937562 — DR. CONSTANTINE G PETERS D.O.
Practice Location Address:

12251 S 80TH AVE
PALOS HEIGHTS, IL
60463-1290

Practice Phone: 708-923-4000
Practice Fax: 708-923-5859

Directions to “ BROOKE MARIE WILSON DMD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.