Individual
DR. DAVID MICHAEL BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3800 N LAKE SHORE DR # 5E, CHICAGO, IL 60613-3301
(310) 498-0555
Mailing address
3800 N LAKE SHORE DR # 5E, CHICAGO, IL 60613-3301
(310) 498-0555
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.009978
IL
103TC0700X
Clinical Psychologist
PSY 20877
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1143651
CAQH IDENTIFIER
—
01
—
1174503403
CIGNA HEALTHCARE/CBH
CA
01
—
OPL208770
BLUE SHIELD OF CALIFORNIA
CA
01
—
W20435
MEDICARE GROUP ID
CA
Enumeration date
01/20/2006
Last updated
08/10/2024
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