Healthcare Provider Details

I. General information

NPI: 1073472809
Provider Name (Legal Business Name): BROOKE ELIZABETH PATZNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3319 N ELSTON AVE
CHICAGO IL
60618-5811
US

IV. Provider business mailing address

3319 N ELSTON AVE
CHICAGO IL
60618-5811
US

V. Phone/Fax

Practice location:
  • Phone: 312-733-0883
  • Fax:
Mailing address:
  • Phone: 312-733-0883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90324
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: