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Brooke Dickens
Student in an Organized Health Care Education/Training Program in Maywood, Illinois
NPI 1578143160

Brooke Dickens is a Student in an Organized Health Care Education/Training Program based in Maywood, IL. Brooke Dickens practices in Maywood, IL. The NPI Number for Brooke Dickens is 1578143160 and holds a License No. (Illinois).

The current practice location address for Brooke Dickens is 2160 S 1St Ave, Maywood, IL and can be reached out via phone at 170-821-6322.

Location: 2160 S 1St Ave, Maywood, IL, 60153-3328
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1578143160
Provider Name
Brooke Dickens
Credential
Provider Entity Type
Individual
Gender
Female
Address
2160 S 1St Ave, Maywood, IL, 60153-3328
Phone Number
170-821-6322
Fax Number
Provider Enumeration Date
04/09/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
F2088607 01 CA DRIVER'S LICENSE
institution
Provider Business Practice Location Address Details
Address
2160 S 1St Ave
City
Maywood
State
Illinois
Zip
60153-3328
Phone Number
170-821-6322
Fax Number
person
Provider Business Mailing Address Details
Address
2160 S 1St Ave
City
Maywood
State
Illinois
Zip
60153-3328
Phone Number
170-821-6322
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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