Provider Demographics
NPI:1124761085
Name:BROWN, SABRINA
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:
Other - Last Name:KUMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-6531
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:695 PARK AVE
Practice Address - Street 2:
Practice Address - City:LAKE VILLA
Practice Address - State:IL
Practice Address - Zip Code:60046-6531
Practice Address - Country:US
Practice Address - Phone:224-541-9100
Practice Address - Fax:224-541-9071
Is Sole Proprietor?:No
Enumeration Date:2022-04-19
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI26640330163W00000X
WI1300033363LF0000X
IL209025465363LF0000X
IL041467446163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse