Individual
MS. PATRICE LYNETTE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1401 S CALIFORNIA AVE, CHICAGO, IL 60608-1858
(773) 522-5841
(773) 522-5868
Mailing address
1401 S CALIFORNIA AVE, CHICAGO, IL 60608-1858
(773) 522-5841
(773) 522-5868
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
525130
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BROPAT88
—
IL
Enumeration date
09/07/2012
Last updated
11/07/2012
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