Individual
BROOKE MARIE FADANELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 S MARION ST, OAK PARK, IL 60302-2809
(708) 383-7500
Mailing address
120 S MARION ST, OAK PARK, IL 60302-2809
(708) 383-7500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14952842
CAQH NUMBER
—
Enumeration date
10/01/2020
Last updated
10/01/2020
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