Brown, Malcolm

Brown, Malcolm is an individual health care provider with primary practice located at 176 N Leclaire Ave , Chicago IL 60644-3413. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Brown, Malcolm can be contacted via phone (773) 688-5299.

Contact Information

Primary practice address
176 N Leclaire Ave Chicago IL 60644-3413
Phone: (773) 688-5299
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X A-2256-0001-A Illinois
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X A-2256-0001-A Illinois

Profile Details

NPI number 1629553748
LBN Legal business name Brown, Malcolm
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2018
Last updated Oct 22nd, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629553748 NPPES
Illinois MEDICAID 1629553748
Illinois MEDICAID 008144
Illinois MEDICAID A-2256-0001-A

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