MEDICARE: MS. SUE ELLEN BROWN MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	146001303	IL

General Provider Information

NPI Number	:	1073771424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUE ELLEN BROWN MS

Provider Business Mailing Address
First Line	:	30W005 SPRUCE CT
Second Line	:
City	:	WARRENVILLE
State	:	IL
Zip	:	60555-1046
Country	:	US
Telephone Number	:	630-536-9293
Fax Number	:

Provider Business Practice Location Address
First Line	:	3965 75TH ST
Second Line	:	SUITE 104
City	:	AURORA
State	:	IL
Zip	:	60504-7925
Country	:	US
Telephone Number	:	630-236-7000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2008
Last Update Date	:	06/01/2008

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