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Individual

MR. MICHAEL BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
AUDIOLOGIST

Contact information

Practice address
3101 FIELDS SOUTH DR, CHAMPAIGN, IL 61822-3743
(217) 366-1243
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-8107

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
147000441
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
205363
MEDICARE GROUP
IL
01
P00002208
RAILROAD MEDICARE
IL
Enumeration date
08/01/2006
Last updated
01/05/2022
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