Mark Joseph Brinkman, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036085346 Issued in IL

Practice address

636 Raymond Drive
Suite 205
Naperville, IL 60563-9791

Phone

(630) 717-2300

Fax

(630) 717-9638

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

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

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.

• Joliet Pediatrics and Family Care Inc

  • Primary Care Clinic/Center
  • Joliet, IL
  • NPI 1619193760

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1053427344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DRIVE",
            "address_2": "SUITE 205",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639791",
            "telephone_number": "630-717-2300",
            "fax_number": "630-717-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 RAYMOND DRIVE",
            "address_2": "SUITE 205",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639791",
            "telephone_number": "630-717-2300",
            "fax_number": "630-717-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKMAN",
        "first_name": "MARK",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036085346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085346",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "2215474",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bright Dental, Inc.
• Bright Haven Behavioral Center, LTD
• Brightcare Home Services LLC
• Brightcare Lacrosse LLC
• Brighter Path Counseling and Psychiatry, PLLC
• Briones Counseling Services
• Paulena Naomi Brocato, DPT
• William Robert Broderick, M.D.
• Anya J Brooks
• Cynthia Ann Brouillard, PSY.D.

• Pediatrics Physician in Naperville, IL
• Providers in Naperville, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.

Verify at the official NPI Registry.