Individual
DIANE MARIE BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4901 W 79TH ST, BURBANK, IL 60459-1554
(708) 346-8268
Mailing address
4901 W 79TH ST FL 2, BURBANK, IL 60459-1569
(708) 499-1545
(708) 499-4862
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-003227
IL
Other
Enumeration date
12/01/2008
Last updated
09/03/2020
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