MALLORY JO BROOKS (NPI# 1467051151) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467051151 |
| Entity Type | Individual |
| Full Name | MALLORY JO BROOKS |
| Credential | NP |
| Practice Address |
2306 E County Road 1800 N Carthage IL 62321-3101 |
| Practice Telephone | 2173577201 |
| Mailing Telephone | 2173577201 |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2020-10-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
202018544 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2306 E COUNTY ROAD 1800 N |
| City | CARTHAGE |
| State | IL |
| Zip Code | 62321-3101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558825364 | Unitypoint At Home | Home Health | 96 S Madison B, Carthage, IL 62321 | 2019-01-25 |
| 1740725340 | Hancock County Senior Services | Assisted Living Facility | 404 S Adams Street, Carthage, IL 62321 | 2017-01-05 |
| 1841431913 | Hancock County Supportive Living | Assisted Living Facility | 400 S Adams Street, Carthage, IL 62321 | 2009-03-18 |
| 1871713602 | Lindsey Wagner | Counselor | 607 Buchanan St, Mental Health Centers of Western Illinois, Carthage, IL 62321 | 2007-04-26 |
| 1134349970 | Joe N Little | Counselor | 607 Buchanan Street, Mental Health Centers of Western Illinois, Carthage, IL 62321 | 2007-04-26 |
| 1427124817 | Mchugh Drug Store LLC | Pharmacy | 70 South Madison St, Carthage, IL 62321 | 2006-11-28 |
| 1619058278 | Charles F Eddingfield Md | General Practice | 25 South Adams Street, Carthage, IL 62321 | 2006-10-18 |
| 1922198910 | Michelle Lee Nelson | Chiropractor | 524 Buchanan St, Carthage, IL 62321 | 2006-10-13 |
| 1104938497 | Richard Lee Vance | Chiropractor | 524 Buchanan, Carthage, IL 62321 | 2006-08-31 |
| 1679038699 | Merritt Family Chiropractic | Chiropractor | 62 S Madison St, Carthage, IL 62321 | 2019-02-04 |
| Find all providers in zip 62321 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700292166 | Anya Jones | Nurse Practitioner | 1100 Highway 16 E, Carthage, MS 39051 | 2014-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881291 | Sarah Zeigler Olsen | Nurse Practitioner | 600 S Randall Rd Ste 220, Algonquin, IL 60102-5937 | 2020-11-02 |
| 1508475294 | Diedra M Ahlert | Nurse Practitioner | 1320 Lexington Dr, Collinsville, IL 62234-4348 | 2020-07-28 |
| 1679182802 | Danielle L Shubert | Nurse Practitioner | 9423 Holy Cross Ln Ste 111, Breese, IL 62230-3510 | 2020-07-23 |
| 1154962900 | Janna Hoppe | Nurse Practitioner | 24600 W 127th St Ste 345, Plainfield, IL 60585-9507 | 2019-10-02 |
| 1841858529 | Katherine R Conkling | Nurse Practitioner | 4941 Benchmark Centre Dr Ste 100, Swansea, IL 62226-2038 | 2019-05-29 |
| 1942767280 | Danielle R Wetzel | Nurse Practitioner | 2040 Ogden Ave Ste 215, Aurora, IL 60504-7205 | 2019-02-22 |
| 1669937231 | Colleen Ann Larkin | Nurse Practitioner | 10939 S Troy St, Chicago, IL 60655-2211 | 2019-02-07 |
| 1568939684 | Katelyn Marie Reed | Nurse Practitioner | 415 N 9th St Ste 4w64, Springfield, IL 62702-5303 | 2018-10-26 |
| 1255813218 | Michelle Christine Bollinger | Nurse Practitioner | 415 N 9th St Ste 4w16, Springfield, IL 62702-5303 | 2018-09-05 |
| 1487160586 | Meghan Doepke Sullivan | Nurse Practitioner | 1030 N Clark St Ste 400, Chicago, IL 60610-5468 | 2017-12-27 |
| Find all providers with the same taxonomy | ||||
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| 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.