Organization Active NPI

Brilliant Women Care, Inc

  • Gynecology Physician
  • Downers Grove, IL
National Provider Identifier
1447713201
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
BRILLIANT WOMEN CARE, INC
Practice address
4121 Fairview Ave
Downers Grove, IL 60515-2264
Phone
(630) 935-2937
NPI assigned
Apr 9, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

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

Authorized official

Name
Mona Gomaa, MDNPI 1225247976
Title
Physician
Phone
(630) 935-2937

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X Primary

Addresses

Primary practice location

4121 Fairview Ave
Downers Grove, IL 60515-2264

Mailing address

7613 W Belmont Ave
Elmwood Park, IL 60707-1113
Phone (630) 935-2937

Other practice location 1

7613 W Belmont Ave
Elmwood Park, IL 60707-1113
Phone (630) 935-2937

Other names 1

  • brilliant women care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200401002711 IL Part B Supplier - Clinic/Group Practice 8921437674 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

810 Biesterfield Rd
Ste 3006
Elk Grove Vlg, IL 60007

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ECJJDD

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585785600000",
    "number": "1447713201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7613 W BELMONT AVE",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607071113",
            "telephone_number": "630-935-2937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 FAIRVIEW AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152264",
            "telephone_number": "630-935-2937"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7613 W Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Elmwood Park",
            "state": "IL",
            "postal_code": "607071113",
            "country_code": "US",
            "telephone_number": "630-935-2937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BRILLIANT WOMEN CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-09",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A",
        "authorized_official_last_name": "GOMAA",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "630-935-2937",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "brilliant women care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "brilliant women care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.