Individual provider Active NPI

Jennifer Khan, CRNA

  • Certified Registered Nurse Anesthetist
  • Chicago, IL
National Provider Identifier
1114257375
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
209.007943 Issued in IL
Practice address
5841 S Maryland Ave
Chicago, IL 60637-1447
Phone
(773) 702-1000
NPI assigned
Jan 10, 2010
Last updated
Feb 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209.007943 IL Primary

Addresses

Primary practice location

5841 S Maryland Ave
Chicago, IL 60637-1447

Mailing address

1464 S Michigan Ave
1207
Chicago, IL 60605-3711
Phone (708) 955-6815

Other names 1

  • Jennifer Brizic Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jbrizic@dacc.uchicago.edu

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221122003469 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517335599 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (888) 824-0200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.007943ILMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Jul 26, 2022 Accepting new patients
The University of Chicago Medical Center CurrentSince Jul 26, 2022 Accepting new patients
University of Chicago CurrentSince Jul 26, 2022 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Interoperability endpoints

  • Direct secure messaging: jbriziccrna14760@uchospital.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1263081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1114257375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1464 S MICHIGAN AVE",
            "address_2": "1207",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053711",
            "telephone_number": "708-955-6815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-702-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "JENNIFER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-10",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209.007943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbrizic@dacc.uchicago.edu",
            "affiliation": "N",
            "address_1": "5841 S Maryland Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606371443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BRIZIC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Feb 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.