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General NPI Number Information
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NPI Number | 1306033469
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Entity Type | Organization
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Legal Business Name | DR. JONATHAN BROWN
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 10/02/2007
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Provider Practice Location Address
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Address Line | 912 IL ROUTE 22
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City | FOX RIVER GROVE
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State | IL
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Zip | 60021-1905
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Country | US
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Telephone | 847-516-7830
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Fax | 847-516-7836
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Provider Business Mailing Address
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Address Line | 912 IL ROUTE 22
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City | FOX RIVER GROVE
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State | IL
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Zip | 60021-1905
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Country | US
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Telephone | 847-516-7830
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Fax | 847-516-7836
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JONATHAN E BROWN
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Credential | D.C.
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Telephone | 847-516-7830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | IL
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