MEDICARE: BROWN CONSULTING SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	71001146	IL

General Provider Information

NPI Number	:	1447476742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROWN CONSULTING SERVICES, INC.

Provider Business Mailing Address
First Line	:	4922 S CORNELL AVE
Second Line	:	UNIT Z
City	:	CHICAGO
State	:	IL
Zip	:	60615-3014
Country	:	US
Telephone Number	:	773-955-5590
Fax Number	:

Provider Business Practice Location Address
First Line	:	4922 S CORNELL AVE
Second Line	:	UNIT Z
City	:	CHICAGO
State	:	IL
Zip	:	60615-3014
Country	:	US
Telephone Number	:	773-955-5590
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROSA M. BROWN VI
Credential	:	PH.D..
Telephone Number	:	773-955-5590

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	09/19/2007

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