Individual provider Active NPI

Brett Riederman, MD

  • Internal Medicine Physician
  • Northbrook, IL
National Provider Identifier
1003375254
Registry record updated Nov 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125.073830 Issued in IL
Practice address
40 Skokie Blvd.
Suite 110
Northbrook, IL 60062-1614
Phone
(224) 407-4400
Fax
(224) 407-2255
NPI assigned
Mar 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.073830 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

40 Skokie Blvd.
Suite 110
Northbrook, IL 60062-1614

Mailing address

950 Technology Way
Suite 250
Libertyville, IL 60048-5366
Phone (224) 407-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 3, 2025 through Oct 3, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Gastrointestinal Health, LLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AAGEBD/Endpoint/AAGEBD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1003375254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 TECHNOLOGY WAY",
            "address_2": "SUITE 250",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485366",
            "telephone_number": "224-407-4400",
            "fax_number": "224-407-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 SKOKIE BLVD.",
            "address_2": "SUITE 110",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621614",
            "telephone_number": "224-407-4400",
            "fax_number": "224-407-2255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIEDERMAN",
        "first_name": "BRETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.073830",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.