Individual
MARY BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-FPA
Contact information
Practice address
25870 HETTICK SCOTTVILLE RD, HETTICK, IL 62649-4791
(217) 416-0641
Mailing address
3309 ROBBINS RD # 590, SPRINGFIELD, IL 62704-6587
(217) 408-4530
(217) 203-2061
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209016051
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
277002936
IL
Other
Enumeration date
10/17/2016
Last updated
10/17/2025
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