Provider Demographics
NPI:1184069890
Name:BROEKER, MAUREEN LEE (MA)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:LEE
Last Name:BROEKER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 BIESTERFIELD RD
Mailing Address - Street 2:BROCK BUILDING SUITE 3008
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3361
Mailing Address - Country:US
Mailing Address - Phone:847-437-0061
Mailing Address - Fax:847-437-0103
Practice Address - Street 1:800 BIESTERFIELD RD
Practice Address - Street 2:BROCK BUILDING SUITE 3008
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3361
Practice Address - Country:US
Practice Address - Phone:847-437-0061
Practice Address - Fax:847-437-0103
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147-000101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147-000101OtherSTATE OF ILLINOIS , LICENSED AUDIOLOGIST