Individual provider Active NPI

Corey Steven Bregman, MD

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1528224045
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
36117979 Issued in IL
Practice address
2300 Childrens'S Plaza, No. 9
Children'S Memorial Hospital
Chicago, IL 60614-3363
Phone
(773) 880-6792
Fax
(773) 880-3517
NPI assigned
Aug 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 036117979 IL
Diagnostic Radiology Physician 2085R0202X 36117979 IL Primary

Addresses

Primary practice location

2300 Childrens'S Plaza, No. 9
Children'S Memorial Hospital
Chicago, IL 60614-3363

Mailing address

2300 Childrens'S Plaza, No. 9
Children'S Memorial Hospital
Chicago, IL 60614-3363
Phone (773) 880-6792

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
I20101104001508 IL Practitioner - Diagnostic RadiologyPractitioner - Pediatric Medicine 5799979514 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036117979ILMDNeuroradiology Physician
36117979ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation Diagnostic Radiology CurrentSince Oct 1, 2014 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Oct 1, 2014 Accepting new patients
Lurie Children'S Medical Group Inc Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6415

225 E Chicago Ave
#118
Chicago, IL 60611

737 N Michigan Ave
Ste 2040
Chicago, IL 60611

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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.

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1528224045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 CHILDRENS'S PLAZA, NO. 9",
            "address_2": "CHILDREN'S MEMORIAL HOSPITAL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143363",
            "telephone_number": "773-880-6792",
            "fax_number": "773-880-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 CHILDRENS'S PLAZA, NO. 9",
            "address_2": "CHILDREN'S MEMORIAL HOSPITAL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143363",
            "telephone_number": "773-880-6792",
            "fax_number": "773-880-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREGMAN",
        "first_name": "COREY",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IL",
            "license": "036117979",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "36117979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.