Individual
MRS. SUSAN MARY BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1813 W KIRBY AVE, CHAMPAIGN, IL 61821-5410
(217) 384-3490
(217) 383-3439
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164003513
IL
Other
Enumeration date
08/01/2006
Last updated
12/26/2014
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