Individual provider Active NPI

Antonio J Bravo, MD

  • Obstetrics & Gynecology Physician
  • Elmhurst, IL
National Provider Identifier
1326139676
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036-078936 Issued in IL
Practice address
133 E Brush Hill Rd Ste 308
Elmhurst, IL 60126-5662
Phone
(331) 221-9006
Fax
(331) 221-2734
NPI assigned
Sep 28, 2006
Last updated
May 24, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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 036-078936 IL Primary

Addresses

Primary practice location

133 E Brush Hill Rd Ste 308
Elmhurst, IL 60126-5662

Mailing address

4201 Winfield Rd FL 4
Warrenville, IL 60555-4025
Phone (331) 221-6377

Other names 1

  • Antonio Jesus Bravo Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address abravo41719@direct.edward.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
I20090605000603 IL Practitioner - Obstetrics/Gynecology 8123178571 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-078936ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Nov 28, 2023 Accepting new patients
Elmhurst Memorial Healthcare CurrentSince May 1, 2011 Accepting new patients
Endeavor Health Medical Group Obstetrics & Gynecology Current Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

133 E Brush Hill Rd
Ste 308
Elmhurst, IL 60126
Phone (331) 221-9006

172 E Schiller St
Elmhurst, IL 60126
Phone (331) 221-6377

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

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

4201 Winfield Rd
Fl 4
Warrenville, IL 60555

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1326139676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 WINFIELD RD FL 4",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605554025",
            "telephone_number": "331-221-6377",
            "fax_number": "331-221-2357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E BRUSH HILL RD STE 308",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265662",
            "telephone_number": "331-221-9006",
            "fax_number": "331-221-2734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAVO",
        "first_name": "ANTONIO",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-078936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "abravo41719@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "133 E Brush Hill Rd Ste 308",
            "city": "Elmhurst",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601265662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ANTONIO",
            "last_name": "BRAVO",
            "middle_name": "JESUS",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.