Individual provider Active NPI

Eileen Marie Brann, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Oak Park, IL
National Provider Identifier
1336263524
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
715 Lake St
Suite 102
Oak Park, IL 60301-1422
Phone
(708) 386-8570
Fax
(708) 386-8596
NPI assigned
Mar 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X IL Primary

Addresses

Primary practice location

715 Lake St
Suite 102
Oak Park, IL 60301-1422

Mailing address

715 Lake St
Suite 102
Oak Park, IL 60301-1422
Phone (708) 386-8570

Other identifiers 2

IdentifierTypeStateIssuer
01632033OtherILBLUE CROSS BLUE SHILED
0005050581OtherILAETNA PROVIDER NUMBER

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
146002020ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eileen Brann Speech Pathology Services Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336263524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 LAKE ST",
            "address_2": "SUITE 102",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011422",
            "telephone_number": "708-386-8570",
            "fax_number": "708-386-8596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 LAKE ST",
            "address_2": "SUITE 102",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011422",
            "telephone_number": "708-386-8570",
            "fax_number": "708-386-8596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANN",
        "first_name": "EILEEN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHILED",
            "identifier": "01632033",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "0005050581",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.