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General NPI Number Information
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NPI Number | 1083761647
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Entity Type | Individual
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Provider Name | SHEILA RENEE' BROWN D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 06/21/2012
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Provider Practice Location Address
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Address Line | 850 S WABASH AVE SUITE 250
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City | CHICAGO
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State | IL
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Zip | 60605-3641
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Country | US
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Telephone | 312-663-1890
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Fax | 312-663-1895
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Provider Business Mailing Address
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Address Line | PO BOX 6776
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City | CHICAGO
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State | IL
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Zip | 60680-6776
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Country | US
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Telephone | 312-663-1890
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Fax | 312-663-1895
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019019737
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License Number State | IL
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