Provider Demographics
NPI:1679546899
Name:BROW, SIDNEY P (CRNA)
Entity Type:Individual
Prefix:
First Name:SIDNEY
Middle Name:P
Last Name:BROW
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 E WING ST
Mailing Address - Street 2:#182
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-6064
Mailing Address - Country:US
Mailing Address - Phone:847-368-0767
Mailing Address - Fax:847-670-3483
Practice Address - Street 1:126 E WING ST
Practice Address - Street 2:#182
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-6064
Practice Address - Country:US
Practice Address - Phone:847-368-0767
Practice Address - Fax:847-670-3483
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163W00000X
WI163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse