Active NPI
Brett Michael Mahon, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Chicago, IL
National Provider Identifier
1023274271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 036.120861
- Practice address
- 1750 W Harrison St
Jelke, Suite 570
Chicago, IL 60612-3825 - Phone
- (312) 942-5260
- NPI assigned
- Aug 6, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 036.120861 | IL | Primary |
Addresses
Primary practice location
1750 W Harrison St
Jelke, Suite 570
Chicago, IL 60612-3825
Mailing address
1750 W Harrison St
Jelke, Suite 570
Chicago, IL 60612-3825
Phone (312) 942-5260
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.120861 | IL | MD | Anatomic Pathology & Clinical Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295308800000",
"number": "1023274271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1750 W HARRISON ST",
"address_2": "JELKE, SUITE 570",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123825",
"telephone_number": "312-942-5260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 W HARRISON ST",
"address_2": "JELKE, SUITE 570",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123825",
"telephone_number": "312-942-5260"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHON",
"first_name": "BRETT",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-06",
"last_updated": "2011-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IL",
"license": "036.120861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.