Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 036082934 | IL |
NPI | 1013962182 |
---|---|
Provider Name | Dr. Lynn G Brown |
First Address | Kankakee, IL 60901-2942 |
Second Address | Kankakee, IL 60901-2942 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 22/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036082934 | (05) | IL |
G85993 | (02) | IL |