Healthcare Provider Details

I. General information

NPI: 1821571811
Provider Name (Legal Business Name): ADRIANA U BROWN APRN, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2018
Last Update Date: 05/27/2023
Certification Date: 05/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 NE GLEN OAK AVE
PEORIA IL
61637-3833
US

IV. Provider business mailing address

701 PENNY LN
BUFFALO GROVE IL
60089-1342
US

V. Phone/Fax

Practice location:
  • Phone: 309-655-7117
  • Fax:
Mailing address:
  • Phone: 847-785-9292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number209.018105
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number10037
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number10037
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number10037
License Number StateWI
# 5
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number209.018105
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: