Provider Demographics
NPI:1376960872
Name:BROWN, PATRICIA LYNN (APN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LYNN
Last Name:BROWN
Suffix:
Gender:F
Credentials:APN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 NORTH WINFIELD ROAD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60190-1295
Mailing Address - Country:US
Mailing Address - Phone:630-933-4487
Mailing Address - Fax:630-933-2009
Practice Address - Street 1:25 NORTH WINFIELD ROAD
Practice Address - Street 2:SUITE 103
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1295
Practice Address - Country:US
Practice Address - Phone:630-933-4487
Practice Address - Fax:630-933-2009
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.011351363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP01387865OtherMEDICARE RAILROAD (INDIVIDUAL)
ILCA4748OtherMEDICARE RAILROAD (GROUP)
ILF400134008OtherMEDICARE PTAN (INDIVIDUAL)
IL206147OtherMEDICARE PTAN (GROUP)
ILCA4748OtherMEDICARE RAILROAD (GROUP)