Provider Demographics
NPI:1184271538
Name:BROWNE, COURTNEY G (PA-C)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:G
Last Name:BROWNE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:676 N SAINT CLAIR ST STE 850
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3124
Mailing Address - Country:US
Mailing Address - Phone:312-695-6180
Mailing Address - Fax:312-695-6189
Practice Address - Street 1:676 N SAINT CLAIR ST STE 850
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3124
Practice Address - Country:US
Practice Address - Phone:312-695-6180
Practice Address - Fax:312-695-6189
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085007188363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1163410OtherTHE NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS