Provider Demographics
NPI:1467930198
Name:BROWN OSUNMAKINDE, SHARRON MICHELLE
Entity Type:Individual
Prefix:
First Name:SHARRON
Middle Name:MICHELLE
Last Name:BROWN OSUNMAKINDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 STRAUSS LN
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1622
Mailing Address - Country:US
Mailing Address - Phone:708-743-6068
Mailing Address - Fax:
Practice Address - Street 1:6 STRAUSS LN
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1622
Practice Address - Country:US
Practice Address - Phone:708-743-6068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-03
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILCNA376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide