Individual
BROOKE LYNN BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSOT R/L
Contact information
Practice address
17800 KEDZIE AVE, HAZEL CREST, IL 60429-2029
(708) 799-8000
Mailing address
16425 BORMET DR, TINLEY PARK, IL 60477-8227
(708) 262-8853
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.014482
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ELT848366912
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/14/2021
Last updated
10/14/2021
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