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General NPI Number Information
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NPI Number | 1558500223
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Entity Type | Organization
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Legal Business Name | DAVID M BROOKS PHD PSYCHOLOGICAL SERVICES PC
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Dates
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Enumeration Date | 02/19/2009
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 3800 N LAKE SHORE DR # 5E
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City | CHICAGO
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State | IL
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Zip | 60613-3301
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Country | US
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Telephone | 310-498-0555
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 N LAKE SHORE DR # 5E
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City | CHICAGO
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State | IL
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Zip | 60613-3301
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Country | US
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Telephone | 310-498-0555
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Fax |
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Authorized Official
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Title or Position | OWNER AND PRESIDENT
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Name | DR. DAVID MICHAEL BROOKS
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Credential | PH.D.
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Telephone | 310-498-0555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 20877
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TP0814X
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Taxonomy Name | Psychoanalysis Psychologist
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License Number | PSY 20877
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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