Brown, Mary
Brown, Mary is an individual health care provider with primary practice located at 1200 W State St , Rockford IL 61102-2112. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Brown, Mary can be contacted via phone (815) 490-1600.Contact Information
Primary practice address
1200 W State St
Rockford IL 61102-2112
Phone: (815) 490-1600
Fax: (815) 964-3516
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 036088734 | Illinois |
Profile Details
| NPI number | 1750365862 |
|---|---|
| LBN Legal business name | Brown, Mary |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 1st, 2005 |
| Last updated | Apr 22nd, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750365862 | NPPES |
| Illinois | MEDICAID | 036088734 |
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