MEDICARE: REKA BROOKS

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1093531006
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REKA BROOKS

Provider Business Mailing Address
First Line	:	111 W WASHINGTON ST STE 4
Second Line	:
City	:	EAST PEORIA
State	:	IL
Zip	:	61611-2532
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 W WASHINGTON ST STE 4
Second Line	:
City	:	EAST PEORIA
State	:	IL
Zip	:	61611-2532
Country	:	US
Telephone Number	:	309-689-2990
Fax Number	:

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

Provider Enumeration Date	:	11/25/2024
Last Update Date	:	11/25/2024

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Directions to “ REKA BROOKS ” Practice Location

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