Individual
EBONY BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1145 N ALPINE RD, ROCKFORD, IL 61107-3613
(815) 398-2443
Mailing address
2332 ROSE AVE, ROCKFORD, IL 61102-3453
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051298855
IL
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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