Healthcare Provider Details

I. General information

NPI: 1366017253
Provider Name (Legal Business Name): ANN BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 06/25/2021
Certification Date: 06/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 N ARLINGTON HEIGHTS RD
ARLINGTON HEIGHTS IL
60004-6062
US

IV. Provider business mailing address

1270 BAMBURG CT
HANOVER PARK IL
60133-5257
US

V. Phone/Fax

Practice location:
  • Phone: 312-324-4502
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number150103758
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: