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General NPI Number Information
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NPI Number | 1548367535
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Entity Type | Individual
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Provider Name | GREGORY M BROWN DPM
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 19310 S HALSTED ST
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City | GLENWOOD
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State | IL
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Zip | 60425-1562
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Country | US
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Telephone | 708-300-3132
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Fax | 773-790-4034
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Provider Business Mailing Address
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Address Line | JENCARE NEIGHBORHOOD MEDICAL CENTER SOUTH CHICAGO, LLC 2231 E. 95TH STREET
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City | CHICAGO
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State | IL - ILLINOIS
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Zip | 60617
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Country | UM
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Telephone | 773-768-7700
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Fax | 312-276-9660
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 016004793
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License Number State | IL
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