Provider Demographics
NPI:1043748098
Name:CROOKS, AMANDA FRANCES
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:FRANCES
Last Name:CROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:453 N HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-2022
Mailing Address - Country:US
Mailing Address - Phone:630-957-8696
Mailing Address - Fax:
Practice Address - Street 1:483 W 2ND ST
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-2509
Practice Address - Country:US
Practice Address - Phone:630-709-3149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-02
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist