Provider Demographics
NPI:1376923748
Name:BROWN, JUDITH NGOZI (DO)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:NGOZI
Last Name:BROWN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 OGDEN AVE STE 225
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-6193
Mailing Address - Country:US
Mailing Address - Phone:630-978-4800
Mailing Address - Fax:630-978-6791
Practice Address - Street 1:2020 OGDEN AVE STE 225
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-6193
Practice Address - Country:US
Practice Address - Phone:630-978-4800
Practice Address - Fax:630-978-6791
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36148823207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036148823Medicaid