Provider Demographics
NPI:1316968514
Name:BROOKS, BROOKE J (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:J
Last Name:BROOKS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:J
Other - Last Name:GAFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1 WESTBROOK CORPORATE CTR
Mailing Address - Street 2:STE 240
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5745
Mailing Address - Country:US
Mailing Address - Phone:708-236-2673
Mailing Address - Fax:
Practice Address - Street 1:2307 LAPORTE AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-6996
Practice Address - Country:US
Practice Address - Phone:219-477-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31003726A225X00000X
IL056008033225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist