Timothy David Brandt, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

3535252 Issued in IL

Practice address

7906 S Parkside
Burbank, IL 60459

Phone

(708) 636-1173

Fax

(708) 636-1017

NPI assigned

Sep 25, 2006

Last updated

Nov 18, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258502400000",
    "number": "1265532428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7906 S PARKSIDE",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "60459",
            "telephone_number": "708-636-1173",
            "fax_number": "708-636-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7906 S PARKSIDE",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "60459",
            "telephone_number": "708-636-1173",
            "fax_number": "708-636-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDT",
        "first_name": "TIMOTHY",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2009-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "3535252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036053252",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "793111512",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Priscilla Betzelos, DMD
• Bilingual Service Providers Inc.
• Bio-Medical Applications of Illinois, Inc. (Fmcna Dialysis Services of Burbank)
• Dave Bolger, D.O.
• Erin Boncher
• Brentwood Operating Company LLC (Brentwood Sub-Acute Healthcare Center)
• Cheryl Brodzinski
• Diane Marie Brooks, PA-C
• Kaylan Brown
• Tatiana Vitalia Buonicore, APRN-FPA

• Internal Medicine Physician in Burbank, IL
• Providers in Burbank, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.