Individual
MARYLON WILLETTE BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2170 W NAVAJO DR, FREEPORT, IL 61032-0010
(815) 908-9407
Mailing address
1723 W LAUREL ST, FREEPORT, IL 61032-3510
(815) 908-9407
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043110870
IL
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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