NPIMap

Organization Active NPI

Pai Participant 27, PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Willowbrook, IL
National Provider Identifier
1093398539
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
PAI PARTICIPANT 27, PC
Practice address
7050 S Madison St
Willowbrook, IL 60527-5548
Phone
(630) 323-6380
NPI assigned
May 3, 2021
Last updated
Aug 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Authorized official

Name
Brittain Brantley
Title
Acting President
Phone
(302) 300-5138

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

7050 S Madison St
Willowbrook, IL 60527-5548

Mailing address

PO Box 639676
Cincinnati, OH 45263-9676
Phone (859) 291-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210614001032 IL Part B Supplier - Clinic/Group Practice 2668872672 Receives reassigned benefits from 16 practitioners
Practice locations: Ottawa, IL; Waterloo, IL; Vernon Hills, IL; Mendota, IL; Belleville, IL; Glen Carbon, IL; La Salle, IL; Alton, IL

National Provider Directory

National Provider Directory

Locations

505 College Ave
Ottawa, IL 61350
Phone (815) 434-1130

240 Center Dr
Vernon Hills, IL 60061
Phone (847) 367-8100

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1093398539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639676",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639676",
            "telephone_number": "859-291-4800",
            "fax_number": "859-655-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7050 S MADISON ST",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275548",
            "telephone_number": "630-323-6380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAI PARTICIPANT 27, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-03",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "BRANTLEY",
        "authorized_official_first_name": "BRITTAIN",
        "authorized_official_title_or_position": "ACTING PRESIDENT",
        "authorized_official_telephone_number": "302-300-5138"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.