Individual
NICHOLAS MICHAEL BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(319) 400-4327
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(319) 400-4327
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036143090
IL
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
036143090
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101260519
LICENSE
VA
Enumeration date
06/21/2011
Last updated
10/26/2020
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