Individual
MS. JACQUELINE MOSES BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6223 S EBERHART AVE, CHICAGO, IL 60637-3318
(773) 203-2490
(773) 288-5239
Mailing address
6223 S EBERHART AVE, CHICAGO, IL 60637-3318
(773) 203-2490
(773) 288-5239
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
041324679
IL
163W00000X
Registered Nurse
041324679
IL
Other
Enumeration date
05/29/2007
Last updated
01/30/2017
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