Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 036.146477 | IL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 036.146477 | IL |
NPI | 1609294438 |
---|---|
Provider Name | Oluwateniola Brown |
First Address | Chicago, IL 60611-2914 |
Second Address | Chicago, IL 60611-2955 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2014 |
Last Update Date | 29/10/2021 |