Healthcare Provider Details

I. General information

NPI: 1104052513
Provider Name (Legal Business Name): NANCY BUNN BROWN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NANCY BROWN BROWN M.D.

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36100 N BROOKSIDE DR STE 106
GURNEE IL
60031-4572
US

IV. Provider business mailing address

36100 N BROOKSIDE DR STE 106
GURNEE IL
60031-4572
US

V. Phone/Fax

Practice location:
  • Phone: 847-821-9500
  • Fax:
Mailing address:
  • Phone: 847-821-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036.129956
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: