Provider Demographics
NPI:1205858792
Name:BROOKS, ELIZABETH B (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:B
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVENUE/R3
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CLEVELAND CLINIC 9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-1716
Practice Address - Country:US
Practice Address - Phone:216-445-1099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-086339207RR0500X, 208000000X, 2080P0216X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric Rheumatology
No207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7287047OtherAETNA
OH745885OtherBUCKEYE
OH000000368506OtherANTHEM
OH000000525884OtherANTHEM
OH2153851OtherBCMH
OH000000221208OtherUNISON
OH363382OtherWELLCARE
PA0017541850003Medicaid
OH2153851Medicaid
OHBR4161442Medicare PIN
OH363382OtherWELLCARE
OH745885OtherBUCKEYE