Provider Demographics
NPI:1568697043
Name:BROOKE MANAGEMENT CORP
Entity Type:Organization
Organization Name:BROOKE MANAGEMENT CORP
Other - Org Name:BROOKE HEALTH SERVICES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:LEVINE
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-753-9433
Mailing Address - Street 1:7227 MADISON ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-1726
Mailing Address - Country:US
Mailing Address - Phone:708-488-1860
Mailing Address - Fax:
Practice Address - Street 1:7227 MADISON ST
Practice Address - Street 2:SUITE A
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130-1726
Practice Address - Country:US
Practice Address - Phone:708-488-1860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011157251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health