Individual provider Active NPI

Irwin Brown, DO

  • Anesthesiology Physician
  • Maywood, IL
National Provider Identifier
1386615664
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
36070975 Issued in IL
Practice address
2160 S First Ave
(BLDG. 103, RM. 3102)
Maywood, IL 60153
Phone
(708) 216-6462
Fax
(708) 216-1249
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 36070975 IL Primary

Addresses

Primary practice location

2160 S First Ave
(BLDG. 103, RM. 3102)
Maywood, IL 60153

Mailing address

2160 S First Ave
(BLDG. 103, RM. 3102)
Maywood, IL 60153
Phone (708) 216-6462

Other identifiers 1

IdentifierTypeStateIssuer
36070975MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address ibrown12811@direct.luhs.org Direct
FHIR URL https://rxhub.luhs.org/fhir/api/FHIR/DSTU2/ Other

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
I20050817000162 IL Practitioner - Anesthesiology 6800826140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Chicago College of Osteopathy, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36070975ILMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Dec 25, 2019 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Loyola University Medical Center CurrentSince Dec 25, 2019 Accepting new patients

Locations

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2160 S 1st Ave
Bldg 103
Maywood, IL 60153
Phone (708) 216-6462

2160 S 1st Ave
Bldg 108
Maywood, IL 60153
Phone (708) 216-6200

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1386615664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "address_2": "(BLDG. 103, RM. 3102)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-6462",
            "fax_number": "708-216-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S FIRST AVE",
            "address_2": "(BLDG. 103, RM. 3102)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-216-6462",
            "fax_number": "708-216-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "IRWIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "36070975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36070975",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ibrown12811@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S First Ave",
            "address_2": "(BLDG. 103, RM. 3102)",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60153",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://rxhub.luhs.org/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR IPA",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2160 S First Ave",
            "address_2": "(BLDG. 103, RM. 3102)",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.