Provider Demographics
NPI:1851470439
Name:BROWN, LINDA (MPT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MAE
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:1100 CENTRAL AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2666
Mailing Address - Country:US
Mailing Address - Phone:847-644-9870
Mailing Address - Fax:773-467-0988
Practice Address - Street 1:1100 CENTRAL AVE
Practice Address - Street 2:SUITE G
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2666
Practice Address - Country:US
Practice Address - Phone:847-644-9870
Practice Address - Fax:773-467-0988
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-009847225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist