Matthew Brenner-Jedwabnik, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085008342 Issued in IL

Practice address

1801 W Taylor St
Chicago, IL 60612-4795

Phone

(847) 207-6228

NPI assigned

Jul 8, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Illinois Hospital and Clinics Hospital, Chicago, IL, CCN 140150

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbrennerjedwabnik173710@uihealth.direct-ci.com

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.

• The Board of Trustees of the University of Illinois

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1386863819
  Medicare reassignment Care Compare group
• Metro Infectious Disease Consultants, LLC

  • Infectious Disease Physician
  • Burr Ridge, IL
  • NPI 1235125717
  Medicare reassignment NPD
• The Board of Trustees of the University of Illinois

  • Occupational Medicine Physician
  • Chicago, IL
  • NPI 1043727571
  NPD
• The Board of Trustees of the University of Illinois

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1609094739
  NPD
• Metro Infectious Disease Consultants LLC

  • Infectious Disease Physician
  • Jonesboro, GA
  • NPI 1770307191
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Board of Trustees of the University of Illinois

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1861431751
  Care Compare affiliation

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1003487208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124795",
            "telephone_number": "847-207-6228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNER-JEDWABNIK",
        "first_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-08",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085008342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie L Brennan, LCPC
• Thomas P. Brennan, PH.D.
• Vladislava Brennan, APRN
• Clara Elisa Brennecke, M.A. LCPC
• Dana Brenneman, APRN
• Alexander Brenner, MD
• Darren Michael Brenner, M.D.
• Deanna Brenner, LSW
• Lauren Brenner, LCSW
• Mariaelana Brenner, MD

• Physician Assistant in Chicago, IL
• Providers in Chicago, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.