Provider Demographics
NPI:1134456270
Name:BROWN, MICHELLE C (CRNA)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:C
Last Name:BROWN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2413 W ALGONQUIN RD # 608
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-9402
Mailing Address - Country:US
Mailing Address - Phone:847-462-9486
Mailing Address - Fax:847-462-9493
Practice Address - Street 1:1555 BARRINGTON RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1019
Practice Address - Country:US
Practice Address - Phone:847-490-6932
Practice Address - Fax:847-884-3677
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-350232367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041-350232OtherILLINOIS LICENSE