Charles Brown, M.D.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

036.040415 Issued in IL

Practice address

333 Skokie Blvd
Suite 112
Northbrook, IL 60062-1613

Phone

(224) 205-7866

NPI assigned

Dec 14, 2016

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481673600000",
    "number": "1225572928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 INDIAN TREE DR",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600355243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SKOKIE BLVD",
            "address_2": "SUITE 112",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621613",
            "telephone_number": "224-205-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "CHARLES",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-14",
        "last_updated": "2016-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IL",
            "license": "036.040415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brookdale Living Communities of Illinois-GV, LLC
• Brooke Kayman Fox, Inc.
• Dy-Mond Brooks
• Larry Brooks, LCSW
• Ellen Katz Brosamle, LMFT
• Karen Brown, LCPC
• Katherine Gorr Brown, BS
• Kirstin D Brown
• Milicia Brown, RBT-18-68761
• Tiffany Tanisha Brown

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.