Provider Demographics
NPI:1336170380
Name:SCHERER, BROOKE DIVINE (MD)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:DIVINE
Last Name:SCHERER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:R
Other - Last Name:DIVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2007 95TH ST
Mailing Address - Street 2:LL - A CHILDRENS HEALTH PARTNERS, SC
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-8459
Mailing Address - Country:US
Mailing Address - Phone:630-848-1700
Mailing Address - Fax:630-848-1718
Practice Address - Street 1:2007 95TH ST
Practice Address - Street 2:LL - A CHILDRENS HEALTH PARTNERS, SC
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8459
Practice Address - Country:US
Practice Address - Phone:630-848-1700
Practice Address - Fax:630-848-1718
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-113455208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02223542Medicare UPIN