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General NPI Number Information
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NPI Number | 1578377198
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Entity Type | Individual
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Provider Name | MOLLY BANFIELD BREWSTER PERRY DNP, RN
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Gender | Female
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 211 E ONTARIO ST STE 700
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City | CHICAGO
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State | IL
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Zip | 60611-3281
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Country | US
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Telephone | 312-926-0001
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Fax | 312-926-4588
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Provider Business Mailing Address
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Address Line | 211 E ONTARIO ST STE 700
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City | CHICAGO
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State | IL
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Zip | 60611-3281
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Country | US
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Telephone | 312-926-0001
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Fax | 312-926-4588
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041386441
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 209032258
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License Number State | IL
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