Jennifer Boothe Brobst, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071007544 Issued in IL

Practice address

18W100 22ND St
Suite 130
Oakbrook Terrace, IL 60181-4499

Phone

(630) 424-9204

Fax

(630) 424-9208

NPI assigned

Jan 24, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oakbrook Behavioral Health LTD

  • Psychiatry Physician
  • Downers Grove, IL
  • NPI 1235235730
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232755200000",
    "number": "1104064443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 387",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601010387",
            "telephone_number": "630-495-8702",
            "fax_number": "630-495-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18W100 22ND ST",
            "address_2": "SUITE 130",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814499",
            "telephone_number": "630-424-9204",
            "fax_number": "630-424-9208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROBST",
        "first_name": "JENNIFER",
        "middle_name": "BOOTHE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-24",
        "last_updated": "2009-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071007544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mesha Rena Blackwell
• Abigail Boateng-Sarpong
• Antonella Aida Botto, DDS
• Marijosephe Pierre Bradford, LCPC
• Katherine Bratkiv, PA-C
• Nicole Brod, D.C.
• Judith Brown
• Charles E Burda, MD
• Cindy Burton
• Shannon Marie Callahan, LPC

• Clinical Psychologist in Oakbrook Terrace, IL
• Providers in Oakbrook Terrace, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.