Provider Demographics
NPI:1770286866
Name:FORBES, BROOKE MARIE (LMT)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:MARIE
Last Name:FORBES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 NAPER VL WHEATON RD STE 209A
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1561
Mailing Address - Country:US
Mailing Address - Phone:630-363-2117
Mailing Address - Fax:
Practice Address - Street 1:1555 NAPER VL WHEATON RD STE 209A
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1561
Practice Address - Country:US
Practice Address - Phone:630-363-2117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227009588225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist