NPIMap

Organization Active NPI

Brook Clinic Associates, P.C.

  • Clinical Psychologist
  • Oak Brook, IL
National Provider Identifier
1811065121
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
071-001939 Issued in IL
Legal business name
BROOK CLINIC ASSOCIATES, P.C.
Practice address
210 W 22ND St
Suite 118
Oak Brook, IL 60523-1544
Phone
(630) 571-1077
NPI assigned
Dec 4, 2006
Last updated
Nov 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Authorized official

Name
Dr. Gerald M. Stein, PH.D.NPI 1043366297
Title
President
Phone
(630) 571-1077

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X 071-001939 IL
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 071-001939 IL Primary
Health Service PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TH0100X 071-001939 IL

Addresses

Primary practice location

210 W 22ND St
Suite 118
Oak Brook, IL 60523-1544

Mailing address

210 W 22ND St
Suite 118
Oak Brook, IL 60523-1544
Phone (630) 571-1077

National Provider Directory

National Provider Directory

Locations

210 W 22nd St
Ste 118
Oak Brook, IL 60523
Phone (630) 541-3376

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226534400000",
    "number": "1811065121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W 22ND ST",
            "address_2": "SUITE 118",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231544",
            "telephone_number": "630-571-1077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W 22ND ST",
            "address_2": "SUITE 118",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231544",
            "telephone_number": "630-571-1077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOK CLINIC ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-11-13",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-571-1077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071-001939",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-001939",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Health Service",
            "state": "IL",
            "license": "071-001939",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; 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.