Individual
CICELY SIMONE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA- C
Contact information
Practice address
4177 S ARCHER AVE, CHICAGO, IL 60632-1849
(773) 932-1142
Mailing address
8543 W 102ND TER, BUILDING 4, APT 313, PALOS HILLS, IL 60465-1347
(773) 824-6005
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.004015
IL
Other
Enumeration date
11/26/2011
Last updated
04/22/2021
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