Provider Demographics
NPI:1912765413
Name:MYERBERG, BROOKE (PSY D)
Entity Type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:
Last Name:MYERBERG
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 N MARSHFIELD AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-3956
Mailing Address - Country:US
Mailing Address - Phone:443-929-2460
Mailing Address - Fax:
Practice Address - Street 1:820 W JACKSON BLVD STE 515
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3061
Practice Address - Country:US
Practice Address - Phone:312-718-3336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.011166103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical