Sandra Brooks
Individual provider Active NPI Behavior Analyst · Park Forest, IL
NPI 1124422472 · NPPES record last updated Oct 15, 2014
Key facts
- NPI
- 1124422472
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- Practice address
- 73 Westwood Dr
Park Forest, IL 60466-1414 - Phone
- (708) 444-1012
- NPI assigned
- Oct 15, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grand Prairie Services | Past | Accepting new patients | |
| Grand Prairie Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Yes |
Addresses
Primary practice location
73 Westwood Dr
Park Forest, IL 60466-1414
Mailing address
17746 Oak Park Ave
Tinley Park, IL 60477-3936
Phone (708) 444-1012
Other providers in Park Forest, IL
- Luisito Perez Benin
- Blackbag Home Physician Service LLC
- Bombeau Lux, LLC
- Sandra Dionne Brand
- Teri Broadnax
- Kenyetta N. Broughton-Floyd
- Brown Bear Early Intervention LLC
- Anita Marie Brown
- Ariana Brown
- Kenneth Brown
All providers in Park Forest, IL · Behavior Analyst in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.