Provider Demographics
NPI:1184946881
Name:BRINCKERHOFF, NANCY JEAN (MSED)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:JEAN
Last Name:BRINCKERHOFF
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:JEAN
Other - Last Name:MOODY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:326 S KENSINGTON CT
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-5832
Mailing Address - Country:US
Mailing Address - Phone:847-991-1663
Mailing Address - Fax:
Practice Address - Street 1:326 S KENSINGTON CT
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-5832
Practice Address - Country:US
Practice Address - Phone:847-991-1663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator