Organization
BRUCE A. BROWN, M.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE A BROWN M.D. (PRESIDENT, PHYSICIAN)
(847) 782-8349
Entity
Organization
Contact information
Practice address
6440 GRAND AVE, SUITE 206, GURNEE, IL 60031-5257
(847) 782-8349
(847) 782-8546
Mailing address
PO BOX 222, DEERFIELD, IL 60015-0222
(847) 405-0654
(847) 405-0658
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04921836
BLUE CROSS BLUR SHIELD
—
Enumeration date
02/16/2007
Last updated
10/29/2007
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