Individual provider Active NPI

Brian Patrick Farrell, MD

  • Otolaryngology Physician
  • Orland Park, IL
National Provider Identifier
1558320747
Registry record updated May 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
036065409 Issued in IL
Practice address
16001 108TH Ave
Orland Park, IL 60467-8788
Phone
(708) 460-0007
Fax
(708) 460-0005
NPI assigned
Mar 17, 2006
Last updated
May 17, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 036065409 IL Primary

Addresses

Primary practice location

16001 108TH Ave
Orland Park, IL 60467-8788

Mailing address

16001 108TH Ave
Orland Park, IL 60467-8788
Phone (708) 460-0007

Other identifiers 1

IdentifierTypeStateIssuer
036065406MedicaidIL

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
I20101011000239 IL Practitioner - Otolaryngology 0648269522 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Sep 15, 2010 Accepting new patients
Century Ear Nose and Throat - Head and Neck Surgery Associates LTD Otolaryngology CurrentSince Jan 1, 1987 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Sep 15, 2010 Accepting new patients
Midwest ENT Alliance PLLC Otolaryngology PastSince Nov 1, 2024 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

1900 Silver Cross Blvd
New Lenox, IL 60451
Phone (815) 300-7106

10660 W 143rd St
Orland Park, IL 60462
Phone (219) 838-0066

16001 108th Ave
Orland Park, IL 60467
Phone (708) 460-0007

16001 108th Ave
Ste A2
Orland Park, IL 60467
Phone (708) 460-0007

9550 W 167th St
Orland Park, IL 60467
Phone (708) 478-7437

Organizations & group practices 4

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210982400000",
    "number": "1558320747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16001 108TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678788",
            "telephone_number": "708-460-0007",
            "fax_number": "708-460-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16001 108TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604678788",
            "telephone_number": "708-460-0007",
            "fax_number": "708-460-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2008-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036065409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036065406",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.