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General NPI Number Information
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NPI Number | 1750269387
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Entity Type | Individual
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Provider Name | BENJAMIN BROWN
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Gender | Male
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 255 E LAKE ST STE 200&106
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1287
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Country | US
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Telephone | 815-295-5470
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Fax |
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Provider Business Mailing Address
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Address Line | 267 N WALNUT ST
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City | ELMHURST
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State | IL
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Zip | 60126-2655
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Country | US
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Telephone | 630-841-2011
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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