Healthcare Provider Details

I. General information

NPI: 1033027776
Provider Name (Legal Business Name): CONNOR BROWN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 5TH AVE
NAPERVILLE IL
60563-3100
US

IV. Provider business mailing address

200 E 5TH AVE
NAPERVILLE IL
60563-3100
US

V. Phone/Fax

Practice location:
  • Phone: 331-457-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: