Provider Demographics
NPI:1790828507
Name:SHERON B. BROWN M.D., P.C.
Entity Type:Organization
Organization Name:SHERON B. BROWN M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERON
Authorized Official - Middle Name:B
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-416-1375
Mailing Address - Street 1:1020 E OGDEN AVE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8609
Mailing Address - Country:US
Mailing Address - Phone:630-416-1375
Mailing Address - Fax:630-416-1378
Practice Address - Street 1:1020 E OGDEN AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8609
Practice Address - Country:US
Practice Address - Phone:630-416-1375
Practice Address - Fax:630-416-1378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036083670261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
588370Medicare ID - Type Unspecified
F37235Medicare UPIN