Provider Demographics
NPI:1609294438
Name:BROWN, OLUWATENIOLA (MD)
Entity Type:Individual
Prefix:
First Name:OLUWATENIOLA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:250 E SUPERIOR ST STE 5-2113
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2914
Mailing Address - Country:US
Mailing Address - Phone:312-472-3874
Mailing Address - Fax:312-472-3690
Practice Address - Street 1:676 N SAINT CLAIR ST STE 950
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2955
Practice Address - Country:US
Practice Address - Phone:312-694-7337
Practice Address - Fax:312-695-0156
Is Sole Proprietor?:No
Enumeration Date:2014-03-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.146477207V00000X, 207VF0040X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology