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NPI Code Detail

MEDICARE: MOLLY BANFIELD BREWSTER PERRY DNP, RN

MEDICARE: MOLLY BANFIELD BREWSTER PERRY DNP, RN
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
1163W00000XRegistered Nurse041386441IL
2363L00000XNurse Practitioner209032258IL

General Provider Information

NPI Number : 1578377198
Entity Type Code : Individual
Provider Name (Legal Business Name) : MOLLY BANFIELD BREWSTER PERRY DNP, RN
Provider Business Mailing Address
First Line : 211 E ONTARIO ST STE 700
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3281
Country : US
Telephone Number : 312-926-0001
Fax Number : 312-926-4588
Provider Business Practice Location Address
First Line : 211 E ONTARIO ST STE 700
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3281
Country : US
Telephone Number : 312-926-0001
Fax Number : 312-926-4588
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2025
Last Update Date : 06/19/2025

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