Healthcare Provider Details

I. General information

NPI: 1679887202
Provider Name (Legal Business Name): MARC A. BROWNING PSY.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2010
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 N MILL ST STE 100
NAPERVILLE IL
60563-2047
US

IV. Provider business mailing address

1335 N MILL ST STE 100
NAPERVILLE IL
60563-2047
US

V. Phone/Fax

Practice location:
  • Phone: 630-646-8013
  • Fax: 630-646-8007
Mailing address:
  • Phone: 630-646-8013
  • Fax: 630-646-8007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071 007887
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: