Brad K Greenspan

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

BRAD K GREENSPAN

Practice address

480 Elm PL Ste 104
Highland Park, IL 60035-2535

Phone

(847) 436-1300

NPI assigned

May 19, 2021

Organization subpart

No

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

Authorized official

Name

Shirley Roll

Title

Enrollment Manager

Phone

(317) 472-7396

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brad K. Greenspan, M.D.

  • Psychiatry Physician
  • Bannockburn, IL
  • NPI 1073604138
  NPD (past)

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1356915656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 ELM PL STE 104",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352535",
            "telephone_number": "847-436-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 ELM PL STE 104",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352535",
            "telephone_number": "847-436-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAD K GREENSPAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "ROLL",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "317-472-7396"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miranda Borkan, LSW
• Estes Boshes, DDS
• Verina Nazih Botros, PHARMD
• Robin Boushie, OTR
• Mark Bouwmeester
• Catherine Anne Brait, MS PT
• Carolyn Ann Braverman, LCPC
• Nathan Alan Braverman, D.M.D., M.D.
• Kenneth Breger, MD
• Jan Brenner, MA-CCC-SLP

• All providers in Highland Park, IL
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.