Individual
ELSIE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDS
Contact information
Practice address
801 W BOULEVARD ST, MARION, IL 62959-1737
(618) 922-8320
(618) 998-5883
Mailing address
PO BOX 548, MARION, IL 62959-0548
(618) 922-8320
(618) 998-5883
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
EB20880999P
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EB20880999P
EVALUATOR CREDENTIAL
IL
Enumeration date
05/01/2007
Last updated
07/08/2007
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