Individual
TIFFANY BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1243 W 97TH ST, CHICAGO, IL 60643-1415
(312) 636-1162
(773) 941-8251
Mailing address
1243 W 97TH ST, CHICAGO, IL 60643-1415
(312) 636-1162
(773) 941-8251
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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