Active NPI
Blaire Broers Brown, DPT
- Orthopedic Physical Therapist
- Chicago, IL
National Provider Identifier
1083936256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 070016918
- Practice address
- 2929 N Southport Ave
Chicago, IL 60657-6945 - Phone
- (773) 665-9947
- NPI assigned
- Feb 16, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 070016918 | IL | Primary |
Addresses
Primary practice location
2929 N Southport Ave
Chicago, IL 60657-6945
Mailing address
2929 N Southport Ave
Chicago, IL 60657-6945
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070016918 | IL | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383091200000",
"number": "1083936256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2929 N SOUTHPORT AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606576945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2929 N SOUTHPORT AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606576945",
"telephone_number": "773-665-9947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "BLAIRE",
"middle_name": "BROERS",
"name_prefix": "Ms.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-16",
"last_updated": "2013-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "IL",
"license": "070016918",
"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 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.