Audrey Genniel Brewer, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036128893 Issued in IL

Practice address

3860 W Ogden Ave
Chicago, IL 60623-2460

Phone

(872) 588-3000

NPI assigned

Sep 15, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Lawndale Christian Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1245289214

  Corporate Officer

  CMS ownership
• Lawndale Christian Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1396986147

  Corporate Officer

  CMS ownership

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.

• Lurie Children'S Medical Group Inc

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1518064716

  IL, Pediatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358294400000",
    "number": "1477835544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232460",
            "telephone_number": "872-588-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232460",
            "telephone_number": "872-588-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "AUDREY",
        "middle_name": "GENNIEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-15",
        "last_updated": "2013-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036128893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy Bretz, COTA
• Karen Bretz, APN
• Sarah Brew, OTR/L
• Brewer Chiropractic, LTD
• Artrice Brewer
• Brent Brewer, D.C.
• Charles Daniel Brewer, PSY.D.
• Erika Brewer, MD
• Erin Brewer
• Gaynell Brewer

• All providers in Chicago, IL
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.