Provider Information for 1215279062
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RANISAH BROWN
Sex: Female
NPI: 1215279062
Last Updated: 2025-03-11
Certification Date: 2025-03-11
Certification Date: 2025-03-11
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1215279062 | ||||||||||||
| Enumeration Date | 2013-03-20 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 6106 WINTERHAVEN DR JOLIET, IL 60431-7446 United States Phone: 815-671-3225 | Fax: | ||||||||||||
| Primary Practice Address | 6106 WINTERHAVEN DR JOLIET, IL 60431-7446 United States Phone: 815-671-3225 | Fax: | ||||||||||||
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