MALCOLM BROWN (NPI# 1629553748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629553748 |
| Entity Type | Individual |
| Full Name | MALCOLM BROWN |
| Practice Address |
176 N Leclaire Ave Chicago IL 60644-3413 |
| Practice Telephone | 7736885299 |
| Mailing Telephone | 7736885299 |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-10-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
A-2256-0001-A | IL | Behavioral Health & Social Service Providers |
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
A-2256-0001-A | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 008144 | 05 | |
| IL | 1629553748 | 05 | |
| IL | A-2256-0001-A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134435522 | Malcolm Michael Brown | Pediatrics | 62 Upper Main Street, Box 584, Sharon, CT 06069-2008 | 2010-08-24 |
| 1871985762 | Malcolm Brown | Specialist/Technologist | 1500 N Patterson St, Athletic Field House Room 1018, Valdosta, GA 31698-0100 | 2015-03-02 |
| 1811953839 | Malcolm D Brown | General Practice | 4212 Carmichael Ct N, Montgomery, AL 36106-3621 | 2006-04-26 |
| 1902866940 | Malcolm Mcdougal Brown | Specialist | 1900 S Hawthorne Rd, Suite 512-a, Winston-salem, NC 27103-3913 | 2006-03-24 |
| Street Address |
176 N LECLAIRE AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60644-3413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710535638 | Marta Yvonne Palmer | Technician | 5008 W Adams, Chicago, IL 60644 | 2019-09-04 |
| 1861056848 | B U I L D Incorporated | Social Worker | 5100 W Harrison St., Chicago, IL 60644 | 2019-04-25 |
| 1851806269 | Habilitative Systems, Inc. | Case Management | 4732 W Ohio St, Chicago, IL 60644 | 2017-12-07 |
| 1336408665 | Meghan Nancy Daw | Dietitian, Registered | 646 S Central Ave, Chicago, IL 60644 | 2012-05-07 |
| 1164790515 | Elizabeth Eleanor Reid-tate | Pharmacist | 5222 W. Madison Avenue, Chicago, IL 60644 | 2011-12-13 |
| 1134458466 | Power Teen Program | Psychologist | 300 N Central Ave, Chicago, IL 60644 | 2009-12-16 |
| 1417198342 | Betty Jean Lofton | Counselor | 5938 W. Midway Park, Chicago, IL 60644 | 2009-03-24 |
| 1881856094 | Sanjay M. Patel M.d. S.c. | Psychiatry & Neurology | 5730 W. Roosevelt Road, Chicago, IL 60644 | 2008-06-29 |
| 1639348691 | Ysl Care, Inc | Community Based Residential Treatment Facility, Mental Illness | 5107-21 West Jackson Blvd, Chicago, IL 60644 | 2008-02-25 |
| 1073795845 | Maryanne Rakidzioski | Occupational Therapist | 5103 W Jackson Blvd, Chicago, IL 60644 | 2007-12-03 |
| Find all providers in zip 60644 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| 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 |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215208491 | Fred M Levin Md Sc | Psychiatry & Neurology | 111 N. Wabash Avenue, Suite 1022, Chicago, IL 60602-1903 | 2012-01-20 |
| 1548697618 | Connections Medical Group Associates LLC | Psychiatry & Neurology | 917 W Washington Blvd, Unit #113, Chicago, IL 60607-2203 | 2013-10-03 |
| 1700086220 | Carol Lynn Childers | Psychiatry & Neurology | 25 E Washington St, #1726, Chicago, IL 60602-1708 | 2007-07-23 |
| 1750415261 | Shelley J. Korshak | Psychiatry & Neurology | 30 N Michigan Ave, Suite 700, Chicago, IL 60602-3402 | 2007-03-15 |
| 1093864449 | Joseph Richard Spatafora | Psychiatry & Neurology | 600 North Mcclurg Court, Suite 4411a, Chicago, IL 60611 | 2007-01-08 |
| 1477639078 | Parveen Azam | Psychiatry & Neurology | 820 S Damen Ave, Chicago, IL 60612-3728 | 2006-10-27 |
| 1568472819 | Roseland Community Hospital Association | Psychiatry & Neurology | 45 W 111th St, Chicago, IL 60628-4200 | 2006-08-09 |
| 1003891458 | Roueen Rafeyan | Psychiatry & Neurology | 2525 S Michigan Ave, B-390, Chicago, IL 60616-2333 | 2005-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144741844 | Rose Medical Association, Inc. | Psychiatry & Neurology | 209 W Romeo B Garrett Ave, Peoria, IL 61605-2502 | 2017-07-03 |
| 1568525277 | Usha D Malkerneker | Psychiatry & Neurology | 17100 Dixie Hwy Ste D, Hazel Crest, IL 60429-1485 | 2006-12-18 |
| 1891899258 | Kenneth Lawrence Moore | Psychiatry & Neurology | 12 Tartan Ridge Rd, Burr Ridge, IL 60527-8904 | 2006-09-07 |
| 1508979758 | Charles R Harris | Psychiatry & Neurology | 12230 Cashlenan Ln, New Lenox, IL 60451-2799 | 2006-08-15 |
| 1255340097 | Michael Rachman | Psychiatry & Neurology | 1375 E Schaumburg Road, Suite 260, Schaumburg, IL 60194-3658 | 2006-08-07 |
| 1245217959 | Raymond Christopher Garcia | Psychiatry & Neurology | 8616 Northern Ave, Rockford, IL 61107-5309 | 2005-12-23 |
| 1184610107 | Lucy Ibrahim | Psychiatry & Neurology | 1280 Windham Pkwy, Romeoville, IL 60446-1673 | 2005-09-26 |
| 1528681764 | Holon Inclusive Behavioral Health | Psychiatry & Neurology | 301 S Main St, Dupo, IL 62239-1325 | 2020-05-21 |
| 1013555416 | Mathers Recovery LLC | Psychiatry & Neurology | 81 E Grand Ave, Fox Lake, IL 60020-1557 | 2019-12-16 |
| 1083252480 | Mathers Recovery LLC | Psychiatry & Neurology | 585 Tollgate Rd, Elgin, IL 60123-9323 | 2019-12-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.