Healthcare Provider Details

I. General information

NPI: 1386174571
Provider Name (Legal Business Name): ROBYN LYN BROWNELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2017
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1941 ROHLWING RD
ROLLING MEADOWS IL
60008-1338
US

IV. Provider business mailing address

1941 ROHLWING RD
ROLLING MEADOWS IL
60008-1338
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-0850
  • Fax: 847-618-0859
Mailing address:
  • Phone: 847-618-0850
  • Fax: 847-618-0859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2017020335
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number73148
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036161601
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: