David Michael Brooks, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.009978 Issued in IL

Practice address

3800 N Lake Shore Dr # 5E
Chicago, IL 60613-3301

Phone

(310) 498-0555

NPI assigned

Jan 20, 2006

Last updated

Aug 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2019 through Jan 1, 2027

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chicago Psychoanalytic Institute

  • Psychologist
  • Chicago, IL
  • NPI 1306856950
  NPD (past) Authorized official
• David M Brooks PHD Psychological Services PC

  dba David M Brooks PhD

  • Clinical Psychologist
  • Chicago, IL
  • NPI 1558500223
  Authorized official Same address or phone
• David M Brooks PHD PA

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1063447662
  NPD (past) Authorized official

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723248000000",
    "number": "1174503403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 N LAKE SHORE DR # 5E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133301",
            "telephone_number": "310-498-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 N LAKE SHORE DR # 5E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606133301",
            "telephone_number": "310-498-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 20877",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.009978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "OPL208770",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH IDENTIFIER",
            "identifier": "1143651",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE/CBH",
            "identifier": "1174503403",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "W20435",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1174503403",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Beth A Brooks, PHD, RN
• Byron Desalvio Brooks, PHD
• Calia Brooks
• Cicely Simone Brooks, PA- C
• Claire Brooks
• Elise Beth Brooks, LCSW
• Elizabeth Brooks
• Gene E Brooks, APN NP
• Glenn Brooks
• Greg A Brooks, CRNA

• Clinical Psychologist in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.