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Individual

DR. WILLIE LEE BROWN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
3700 N BELT W, BELLEVILLE, IL 62226-5629
(618) 236-2207
(618) 236-2377
Mailing address
PO BOX 2682, EAST SAINT LOUIS, IL 62202-2682
(618) 236-2207
(618) 236-2377

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
016.004243
IL
213ES0131X
Foot Surgery Podiatrist
2004030548
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0060101305
BCBS OF ILLINOIS
IL
01
016.004243
ILLINOIS LICENSE NO.
IL
05
016004243
IL
01
2004030548
MISSOURI LICENSE NO.
MO
05
303052401
MO
Enumeration date
02/12/2007
Last updated
06/29/2022
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