Active NPI
Gaynell Brewer
- Early Intervention Provider Agency
- Chicago, IL
National Provider Identifier
1033512009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Early Intervention Provider Agency
- License
- 1851219
- Practice address
- 1009 N Monitor Ave
Chicago, IL 60651-2568 - Phone
- (312) 719-5499
- NPI assigned
- Oct 3, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | 1851219 | IL | Primary |
Addresses
Primary practice location
1009 N Monitor Ave
Chicago, IL 60651-2568
Mailing address
1009 N Monitor Ave
Chicago, IL 60651-2568
Phone (312) 719-5499
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1851219 | IL | MD | Early Intervention Provider Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412294400000",
"number": "1033512009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1009 N MONITOR AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606512568",
"telephone_number": "312-719-5499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1009 N MONITOR AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606512568",
"telephone_number": "312-719-5499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREWER",
"first_name": "GAYNELL",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-03",
"last_updated": "2014-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "252Y00000X",
"taxonomy_group": "",
"desc": "Early Intervention Provider Agency",
"state": "IL",
"license": "1851219",
"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 Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.