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General NPI Number Information
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NPI Number | 1912167818
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Entity Type | Individual
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Provider Name | CORY A BROWN MD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2008
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 4025 N SHERIDAN RD
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City | CHICAGO
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State | IL
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Zip | 60613-2010
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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 RD
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City | CHICAGO
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State | IL
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Zip | 60613-2010
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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 |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 036.125611
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036.125611
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License Number State | IL
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