Individual provider Active NPI

Brian M Brown

  • Electroneurodiagnostic Specialist/Technologist
  • Homewood, IL
National Provider Identifier
1275856718
Registry record updated Mar 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Electroneurodiagnostic Specialist/TechnologistTaxonomy code 246ZE0600X
Practice address
3220 185TH PL
Homewood, IL 60430-2701
Phone
(312) 671-0081
NPI assigned
Mar 11, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Electroneurodiagnostic Specialist/Technologist 246ZE0600X Primary
Electroneurodiagnostic Specialist/Technologist 246ZE0600X NOT REQUIRED IL

Addresses

Primary practice location

3220 185TH PL
Homewood, IL 60430-2701

Mailing address

3220 185TH PL
Homewood, IL 60430-2701
Phone (312) 671-0081

Other names 1

  • Balance Medical Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
NOT REQUIREDILMDElectroneurodiagnostic Specialist/Technologist

NPI Registry JSON

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268265600000",
    "number": "1275856718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 185TH PL",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302701",
            "telephone_number": "312-671-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 185TH PL",
            "city": "HOMEWOOD",
            "state": "IL",
            "postal_code": "604302701",
            "telephone_number": "312-671-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BRIAN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-11",
        "last_updated": "2010-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "246ZE0600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Electroneurodiagnostic",
            "state": "IL",
            "license": "NOT REQUIRED",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BALANCE",
            "last_name": "MEDICAL",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Homewood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2010; 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.