Brooks, Greg A

Brooks, Greg A is an individual health care provider with primary practice located at 2875 W 19Th St , Chicago IL 60623-3501. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Brooks, Greg A can be contacted via phone (773) 484-4099.

Contact Information

Primary practice address
2875 W 19Th St Chicago IL 60623-3501
Phone: (773) 484-4099
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 28162626A Indiana
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AP114460 Texas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209009504 Illinois

Profile Details

NPI number 1255322459
LBN Legal business name Brooks, Greg A
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2005
Last updated Mar 17th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255322459 NPPES
Indiana MEDICAID 200508510

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