Fowler, Brenda

Fowler, Brenda is an individual health care provider with primary practice located at 966 W. 21St Street , Chicago IL 60608. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife is her primary health care specialty. Fowler, Brenda can be contacted via phone (773) 254-1400.

Contact Information

Primary practice address
966 W. 21St Street Chicago IL 60608
Phone: (773) 254-1400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 041413998 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 209015043 Illinois

Profile Details

NPI number 1760927800
LBN Legal business name Fowler, Brenda
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2016
Last updated Dec 28th, 2016 - about 9 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 1760927800 NPPES
Illinois MEDICAID PENDING

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