Brook Ernestine Medici, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085005373 Issued in IL

Practice address

1550 N Northwest Hwy
Suite 211
Park Ridge, IL 60068-1411

Phone

(847) 876-9300

NPI assigned

Jan 23, 2015

Last updated

Jan 23, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Lockport Express Medical Group, Inc.

  dba Lockport Express Medical Group

  • Urgent Care Clinic/Center
  • Lockport, IL
  • NPI 1790053643
  Medicare reassignment
• Osf Healthcare System

  • Certified Registered Nurse Anesthetist
  • Monmouth, IL
  • NPI 1811016124
  Medicare reassignment
• Emergency Physicians of Central Florida LLP

  • Emergency Medicine Physician
  • Orlando, FL
  • NPI 1326033341
  Medicare reassignment
• Florida Emergency Physicians Kang and Associates MD LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Orlando, FL
  • NPI 1811983752
  Medicare reassignment
• Osf Healthcare System

  dba OSF Little Company of Mary Medical Center

  • General Acute Care Hospital
  • Evergreen Park, IL
  • NPI 1215572045
  NPD
• Osf Healthcare System

  dba OSF Saint Katharine Medical Center

  • General Acute Care Hospital
  • Dixon, IL
  • NPI 1508683590
  NPD
• Morgan Medical Group, LLC

  • Family Medicine Physician
  • Mount Prospect, IL
  • NPI 1043733504
  NPD (past)

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

{
    "created_epoch": "1421971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421971200000",
    "number": "1578953972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N NORTHWEST HWY",
            "address_2": "SUITE 211",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681411",
            "telephone_number": "847-876-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N NORTHWEST HWY",
            "address_2": "SUITE 211",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681411",
            "telephone_number": "847-876-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDICI",
        "first_name": "BROOK",
        "middle_name": "ERNESTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-23",
        "last_updated": "2015-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desree McNair
• Alexandra Rae McNally, MD
• Miles McNeir, DO
• Medcrescent LLC
• Medex Diagnostics LLC
• Medlab Technologies LLC
• Medtech Devices LLC
• Meersman Acupuncture and Herbal Medicine PLLC
• Megan Brady Counseling, PLLC
• Donna Mehdiyar, DO

• Physician Assistant in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.