| NPI | 1144382268 |
|---|---|
| Other Name | SA BROOKSIDE SPECIALTY CENTER |
| Entity Type | Organization |
| Authorized Contact | DON DANIELS VP 815-966-2084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism |
| Additional Taxonomies | 207K00000X Allergy & Immunology |
| 207RR0500X Internal Medicine Rheumatology | |
| 207Y00000X Otolaryngology | |
| 207YP0228X Otolaryngology Pediatric Otolaryngology | |
| 213E00000X Podiatrist | |
| 231H00000X Audiologist | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2018-07-12 |