MEDICARE: DR. SHERON B BROWN M.D.

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	207Q00000X	Family Medicine Physician	036083670	IL

General Provider Information

NPI Number	:	1174507560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHERON B BROWN M.D.

Provider Business Mailing Address
First Line	:	1860 PAYSPHERE CIR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674-0018
Country	:	US
Telephone Number	:	630-416-1375
Fax Number	:	630-416-1378

Provider Business Practice Location Address
First Line	:	1020 E OGDEN AVE
Second Line	:	SUITE 214
City	:	NAPERVILLE
State	:	IL
Zip	:	60563-8609
Country	:	US
Telephone Number	:	630-416-1375
Fax Number	:	630-416-1378

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	03/10/2014

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