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NPI Code Detail

MEDICARE: BROOKE Y. TRICKEY NP

MEDICARE: BROOKE Y. TRICKEY NP
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
1363LF0000XFamily Nurse Practitioner209009430IL

General Provider Information

NPI Number : 1437423613
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE Y. TRICKEY NP
Provider Business Mailing Address
First Line : 111 W JACKSON BLVD STE 1700
Second Line :
City : CHICAGO
State : IL
Zip : 60604-3597
Country : US
Telephone Number : 888-731-8994
Fax Number :
Provider Business Practice Location Address
First Line : 111 W JACKSON BLVD STE 1700
Second Line :
City : CHICAGO
State : IL
Zip : 60604-3597
Country : US
Telephone Number : 888-731-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2012
Last Update Date : 06/03/2024

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