MEDICARE: KALEB LEE BROWN DC

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	111N00000X	Chiropractor	038.013931	IL

General Provider Information

NPI Number	:	1346958816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KALEB LEE BROWN DC

Provider Business Mailing Address
First Line	:	77 MCLEOD AVE
Second Line	:
City	:	CHARLESTON
State	:	IL
Zip	:	61920-2951
Country	:	US
Telephone Number	:	217-549-7439
Fax Number	:

Provider Business Practice Location Address
First Line	:	710 JACKSON AVE
Second Line	:
City	:	CHARLESTON
State	:	IL
Zip	:	61920-2004
Country	:	US
Telephone Number	:	217-549-7439
Fax Number	:

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

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	06/10/2026

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