Individual
DUSTIN BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
127 STEWART ST, EAST PEORIA, IL 61611-2613
(309) 678-7422
Mailing address
127 STEWART ST, EAST PEORIA, IL 61611-2613
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209019082
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209019082
—
IL
Enumeration date
08/07/2019
Last updated
03/07/2023
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