Revi Chari Manipol Brinkman

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

041472676 Issued in IL

Practice address

9437 S 84TH Ave
Hickory Hills, IL 60457

Phone

(714) 343-7712

NPI assigned

Jun 26, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: revi.chari.brinkman.1@14868.direct.athenahealth.com

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1558047340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9437 S 84TH AVE",
            "city": "HICKORY HILLS",
            "state": "IL",
            "postal_code": "60457",
            "telephone_number": "714-343-7712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9437 S 84TH AVE",
            "city": "HICKORY HILLS",
            "state": "IL",
            "postal_code": "60457",
            "telephone_number": "714-343-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKMAN",
        "first_name": "REVI CHARI",
        "middle_name": "MANIPOL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "041472676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Borskie, PHARMD
• Carly Bowen
• Tricia Lynn Bradley, RD, LDN, MPH
• Brady Enterprises, Inc
• Carol I. Braun, DDS
• Melanie Butenas
• Roscoe Canty, CADC
• Anita Casey
• Ernest Chen, PHARMD
• Chiropractic Health Group, LLC

• All providers in Hickory Hills, IL
• Gerontology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.