Corey Austin Brooks, PA
Individual provider Active NPI Physician Assistant · Shiloh, IL
NPI 1134466485 · NPPES record last updated Apr 21, 2025
Key facts
- NPI
- 1134466485
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 085004575 (IL)
- Practice address
- 1418 Cross St
Div Im Medical Oncology, Ste 180
Shiloh, IL 62269-2914 - Phone
- (618) 607-1340
- Fax
- (618) 622-9724
- NPI assigned
- Jan 7, 2013
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Washington University Physicians in Illinois Inc
Practice addresses (Care Compare)
4500 Memorial Dr
Belleville, IL 62226-5360
Phone (314) 362-7200
Hospital & facility affiliations
- Memorial Hospital
- Barnes Jewish Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130306000471 | IL | Practitioner - Physician Assistant | 3779738216 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Washington University Physicians in Illinois, Inc | Current |
Accepting new patients | |
| Washington University Physicians in Illinois, Inc | Current |
Accepting new patients | |
| Washington University Physicians in Illinois, Inc | Past | Accepting new patients |
Locations
1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240
4 Memorial Dr
Ste 134
Alton, IL 62002
Phone (618) 607-1340
1418 Cross St
Ste 180
Shiloh, IL 62269
Phone (618) 607-1340
1404 Cross St
Shiloh, IL 62269
Phone (618) 607-1000
4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085004575 | IL | Yes |
Addresses
Primary practice location
1418 Cross St
Div Im Medical Oncology, Ste 180
Shiloh, IL 62269-2914
Mailing address
PO Box 7412011
Chicago, IL 60674-2011
Phone (618) 607-1340
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 220143984 | Medicaid | MO |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Washington University |
Other providers in Shiloh, IL
- Evan Blankenship
- Bethany Ilene Bowen
- Brianna Lee Bowles
- John Albert Boyd
- Breeze Operations, LLC
- Ariana Brown
- Mary Brunhaver
- Misty Germaine Burns
- Ca Group, LLC
- Antinia Cage
All providers in Shiloh, IL · Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 21, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.