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Individual

GREG A BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2875 W 19TH ST, CHICAGO, IL 60623-3501
(773) 484-4099
Mailing address
520 N KINGSBURY ST UNIT 3201, CHICAGO, IL 60654-8777
(574) 229-5636

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209009504
IL
367500000X
Certified Registered Nurse Anesthetist
28162626A
IN
367500000X
Certified Registered Nurse Anesthetist
AP114460
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200508510
IN
Enumeration date
11/04/2005
Last updated
03/17/2018
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