MALCOLM BROWN NPI 1629553748

NPI Information

NPI: 1629553748
Provider Name: MALCOLM BROWN
Classification: Psychiatry & Neurology - 2084A0401X
Entity Type: Individual

Specialization: Addiction Medicine

Address:
176 N LECLAIRE AVE
CHICAGO, IL
ZIP 60644
Phone: (773) 688-5299
Get Directions

Malcolm Brown is an addiction medicine psychiatry neurology in Chicago, IL. The provider is a doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine Malcolm Brown NPI is 1629553748. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

176 N LECLAIRE AVE
CHICAGO, IL
ZIP 60644-413
Phone: (773) 688-5299

The enumeration date for this NPI number is 9/25/2018 and was last updated on 10/22/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TA0400X	Psychologist	Addiction (Substance Use Disorder)	A-2256-0001-A	ILLINOIS	No
2	2084A0401X	Psychiatry & Neurology	Addiction Medicine	A-2256-0001-A	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	008144	MEDICAID	ILLINOIS
2	A-2256-0001-A	MEDICAID	ILLINOIS
3	1629553748	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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