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General NPI Number Information
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NPI Number | 1881913531
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Entity Type | Organization
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Legal Business Name | HOWARD BROWN HEALTH CENTER
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Dates
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Enumeration Date | 05/20/2010
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 3501 N HALSTED ST
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City | CHICAGO
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State | IL
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Zip | 60657-1832
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Country | US
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Telephone | 773-388-1600
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Fax | 773-388-8936
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Provider Business Mailing Address
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Address Line | 4025 N SHERIDAN
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City | CHICAGO
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State | IL
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Zip | 60613
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Country | US
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Telephone | 773-388-1600
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Fax | 773-388-8936
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. BURGUNDY JOHNSON
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Credential |
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Telephone | 872-269-3491
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 30411
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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