NPIMap

Organization Active NPI

David Dean Brockman MD SC

  • Psychoanalysis Psychologist
  • Glenview, FL
National Provider Identifier
1023189792
Registry record updated Aug 22, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Psychoanalysis PsychologistTaxonomy code 103TP0814X
License
303699 Issued in IL
Legal business name
DAVID DEAN BROCKMAN MD SC
Practice address
1030 Kenilworth Lane
David Dean Brockman MD SC
Glenview, FL 60025
Phone
(847) 729-0932
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Dean Brockman
Title
President
Phone
(847) 729-0932

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychoanalysis PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TP0814X 303699 IL Primary

Addresses

Primary practice location

1030 Kenilworth Lane
David Dean Brockman MD SC
Glenview, FL 60025

Mailing address

1030 Kenilworth Lane
David Dean Brockman MD SC
Glenview, IL 60025

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023189792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 KENILWORTH LANE",
            "address_2": "DAVID DEAN BROCKMAN MD SC",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "60025",
            "fax_number": "847-729-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 KENILWORTH LANE",
            "address_2": "DAVID DEAN BROCKMAN MD SC",
            "city": "GLENVIEW",
            "state": "FL",
            "postal_code": "60025",
            "telephone_number": "847-729-0932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID DEAN BROCKMAN MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROCKMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-729-0932",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TP0814X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Psychoanalysis",
            "state": "IL",
            "license": "303699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.