Healthcare Provider Details

I. General information

NPI: 1750195111
Provider Name (Legal Business Name): SHEILA LUVENIA BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38703 N SHERIDAN RD # OT90
BEACH PARK IL
60099-3991
US

IV. Provider business mailing address

38703 N SHERIDAN RD LOT 90
BEACH PARK IL
60099-3956
US

V. Phone/Fax

Practice location:
  • Phone: 224-440-2613
  • Fax:
Mailing address:
  • Phone: 224-440-2613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: