Individual provider Active NPI

Maura Brennan, M.D.

  • Obstetrics & Gynecology Physician
  • Park Ridge, IL
National Provider Identifier
1194774570
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036-089546 Issued in IL
Practice address
1875 W Dempster St Ste 360
Park Ridge, IL 60068-1192
Phone
(847) 825-7030
NPI assigned
May 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036-089546 IL Primary

Addresses

Primary practice location

1875 W Dempster St Ste 360
Park Ridge, IL 60068-1192

Mailing address

1875 W Dempster St
Park Ridge, IL 60068-1186
Phone (847) 825-7030

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address mbrennan205243@direct.myadvocateaurora.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050608000347 IL Practitioner - Obstetrics/Gynecology 5890738033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Medical College of Wisconsin, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1775 Dempster St
Park Ridge, IL 60068-1143

1875 Dempster St
Park Ridge, IL 60068-1192

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-089546ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Oct 1, 2014 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Oct 1, 2014 Accepting new patients
Chicago Gastro LLC Past Accepting new patients
Advocate North Side Health Network Past Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

2545 S Ml King Dr
Chicago, IL 60616
Phone (312) 842-7117

75 Remittance Dr
Dept 6994
Chicago, IL 60675

29373 Network Pl
Chicago, IL 60673

1875 W Dempster St
Ste 360
Park Ridge, IL 60068
Phone (847) 825-1100

1875 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-8640

Interoperability endpoints

  • Direct secure messaging: mbrennan205243@direct.myadvocateaurora.org

Organizations & group practices 4

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.

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": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1194774570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 W DEMPSTER ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681186",
            "telephone_number": "847-825-7030",
            "fax_number": "847-825-7047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 W DEMPSTER ST STE 360",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681192",
            "telephone_number": "847-825-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "MAURA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-10",
        "last_updated": "2022-04-19",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-089546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1875 W Dempster St Ste 360",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbrennan205243@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1875 W Dempster St Ste 360",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.