Latoya Brown
Individual provider Active NPI Driver · South Holland, IL
NPI 1285880161 · NPPES record last updated Aug 12, 2008
Key facts
- NPI
- 1285880161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- B65052483839 (IL)
- Practice address
- 430 E 162ND St
Suite 522
South Holland, IL 60473-2258 - Phone
- (773) 344-4016
- Fax
- (708) 575-0432
- NPI assigned
- Aug 12, 2008
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| B65052483839 | IL | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | B65052483839 | IL | Yes |
Addresses
Primary practice location
430 E 162ND St
Suite 522
South Holland, IL 60473-2258
Mailing address
430 E 162ND St
Suite 522
South Holland, IL 60473-2258
Phone (773) 344-4016
Other providers in South Holland, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.