Individual provider Active NPI

Victoria Brander, MD

  • Physical Medicine & Rehabilitation Physician
  • Chicago, IL
National Provider Identifier
1275586554
Registry record updated Jan 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Practice address
680 N Lake Shore Dr
Suite 1028
Chicago, IL 60611-4546
Phone
(312) 664-6848
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X IL Primary

Addresses

Primary practice location

680 N Lake Shore Dr
Suite 1028
Chicago, IL 60611-4546

Mailing address

680 N Lake Shore Dr
Attn: Lilli Kornblum
Chicago, IL 60611-4546
Phone (312) 475-5535

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
I20041213000437 IL Practitioner - Physical Medicine and Rehabilitation 5294792198 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-075655ILMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 12, 2011 Accepting new patients
Endeavor Health Medical Group Physical Medicine & Rehabilitation CurrentSince Dec 12, 2011 Accepting new patients
Pandemic Solutions LLC PastSince Apr 30, 2020 Accepting new patients
Illinois Bone and Joint Institute Past Accepting new patients

Locations

680 N Lake Shore Dr
Ste 1028
Chicago, IL 60611
Phone (312) 335-9333

9532 Eagle Way
Chicago, IL 60678

680 N Lake Shore Dr
Ste 924
Chicago, IL 60611
Phone (312) 475-5628

680 N Lake Shore Dr
Chicago, IL 60611
Phone (312) 503-6000

49 S Waukegan Rd
Ste 200
Deerfield, IL 60015
Phone (847) 945-4575

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2501 Compass Rd
Ste 125
Glenview, IL 60026
Phone (847) 250-1130

1875 W Dempster St
Ste 405
Park Ridge, IL 60068
Phone (312) 372-6644

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/Freedom_IBJI
  • FHIR API: https://epicproxy.et1195.epichosted.com/fhirproxy/api/FHIR/R4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1275586554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "ATTN: LILLI KORNBLUM",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-475-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 1028",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-664-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDER",
        "first_name": "VICTORIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.