Individual provider Active NPI

Mary Brennan Naughton

  • Emergency Medicine Physician
  • Chicago, IL
National Provider Identifier
1477973691
Registry record updated Sep 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036-143784 Issued in IL
Practice address
1653 W Congress Pkwy
Chicago, IL 60612
Phone
(312) 947-0229
NPI assigned
Apr 28, 2014
Last updated
Sep 27, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036-143784 IL Primary

Addresses

Primary practice location

1653 W Congress Pkwy
Chicago, IL 60612

Mailing address

1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone (312) 947-0229

Other practice location 1

808 S Wood St
469 Cme, M/C 724
Chicago, IL 60612-7300
Phone (312) 413-7492

Other names 1

  • Mary Bernadine Brennan Former name

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
I20191007001721 IL Practitioner - Emergency Medicine 7719297167 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-143784ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rush University Medical Group Emergency Medicine CurrentSince Oct 1, 2020 Accepting new patients
Rush University Medical Center CurrentSince Oct 1, 2020 Accepting new patients
Rush Oak Park ER Physicians Group Past Accepting new patients

Locations

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1653 W Congress Pkwy
#1
Chicago, IL 60612
Phone (312) 947-0229

1653 W Congress Pkwy
#177
Chicago, IL 60612
Phone (312) 947-0229

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

75 Remittance Dr
Dept 1611
Chicago, IL 60675

Interoperability endpoints

  • Direct secure messaging: mnaughton156230@direct.rush.rush-health.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1477973691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-947-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-947-0229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 S Wood St",
            "address_2": "469 CME, M/C 724",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127300",
            "country_code": "US",
            "telephone_number": "312-413-7492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAUGHTON",
        "first_name": "MARY",
        "middle_name": "BRENNAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-28",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-143784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "BRENNAN",
            "middle_name": "BERNADINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.