BROOKE BALL


Address: 203 Constitution Dr Sw # B, Poplar Grove, IL 61065-8729
Phone: 8153555369

BROOKE BALL (NPI# 1366063539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366063539
Entity Type Individual
Full Name BROOKE BALL
Credential CNA
Practice Address 203 Constitution Dr Sw # B
Poplar Grove
IL 61065-8729
Practice Telephone 8153555369
Enumeration Date 2020-04-29
Last Update Date 2020-04-29
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 251J00000X Nursing Care Agencies
Y 3747A0650X Technician
Specialization: Attendant Care Provider
Nursing Service Related Providers

Other Provider Identifier

State Issuer Identifier Type Code
NONE NONE 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
4919 Rolex Pkwy, Loves Park, IL 611116223 8153555369

Office Location

Street Address 203 CONSTITUTION DR SW # B
City POPLAR GROVE
State IL
Zip Code 61065-8729

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992352819 Amber Suarez-christensen Occupational Therapist 4950 Il-173, Poplar Grove, IL 61065 2019-08-26
1588227300 Kimberly Jozwiak Counselor 4950 Rte. 173, Poplar Grove, IL 61065 2019-04-17
1902252075 Pioneer Center Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 310 Constitution Drive Sowth West, Poplar Grove, IL 61065 2016-05-09
1568738821 Ashley Lynn Moritz Speech-Language Pathologist 4950 Route 173, Poplar Grove, IL 61065 2012-03-30
1326202441 Felker Pharmacy Inc Pharmacy 13521 Illinois Rt 76, Poplar Grove, IL 61065 2008-07-17
1295744183 William M Bitsas Family Medicine 406 Maple Leaf Ln, Poplar Grove, IL 61065 2006-08-07
1790718104 Troy Michael Doetch Family Medicine 1200 Candlewick Dr Nw, Poplar Grove, IL 61065 2006-07-09
1548667371 Gemma Fletcher Physical Therapist 4950 Route 173, Poplar Grove, IL 61065 2014-11-21
1700207768 Kathy Blackmer Counselor 13508 Julie Dr, Poplar Grove, IL 61065 2013-12-18
1598883670 Jeffry Stephen Clow Speech-Language Pathologist 492 Prairie Knoll Dr, Poplar Grove, IL 61065-7817 2007-03-27
Find all providers in zip 61065

Taxonomy Information

Taxonomy Code 3747A0650X
Grouping Nursing Service Related Providers
Classification Technician
Specialization Attendant Care Provider

Taxonomy Definition

An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1396392189 Mark Currier Technician 103 Bradford Pl Se, Poplar Grove, IL 61065-8780 2019-08-26

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1881294874 Paulette Lovelace Technician 521 Vicksburg Dr, Belleville, IL 62221-6670 2020-10-28
1891395893 Cheryl Lynn Eubanks Technician 1710 Mccasland Ave, East Saint Louis, IL 62207-2245 2020-10-28
1043818446 Sabrina Marie Williams Technician 211 S Lodge St, Shelbyville, IL 62565-1951 2020-10-16
1124626213 Tonya Lee Burdell Technician 315 S Douglas St, Litchfield, IL 62056-1851 2020-10-12
1720685704 Itzayana Rodriguez Technician 5037 Carol Ct, Rockford, IL 61108-4157 2020-10-02
1871108209 Ashley Marie Dawkins Technician 528 Grant Dr, Quincy, IL 62301-7234 2020-09-11
1104437797 Stephen T Medford Technician 1017 Hartman Ln, O Fallon, IL 62269-7207 2020-08-16
1528685088 Maxine Washington Technician 2014 S. 17th Ave., Broadview, IL 60155-2906 2020-07-01
1316562788 Salli Jacobsen Technician 6699 Torch Lite Tr, Loves Park, IL 61111 2020-06-11
1356962377 Brenda Lou Isermann Technician 406 W South 2nd St, Shelbyville, IL 62565-2114 2020-04-30
Find all providers with the same taxonomy

Competitor

Search similar providers

City POPLAR GROVE
Zip Code 61065

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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