Basic Information
| Provider Information | |||||||||
| NPI: | 1457449167 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BELCHER | ||||||||
| FirstName: | BROOKE | ||||||||
| MiddleName: | ALLYSON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 929 W HIGGINS RD | ||||||||
| Address2: | |||||||||
| City: | SCHAUMBURG | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601953203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472854200 | ||||||||
| FaxNumber: | 8478850130 | ||||||||
| Practice Location | |||||||||
| Address1: | 929 W HIGGINS RD | ||||||||
| Address2: | |||||||||
| City: | SCHAUMBURG | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601953203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472854200 | ||||||||
| FaxNumber: | 8478850130 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2006 | ||||||||
| LastUpdateDate: | 07/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 07/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 036-120234 | IL | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 036-120234 | 05 | IL | MEDICAID | P00617709 | 01 | IL | MEDICARE RAILROAD | OTHER |