Malcolm K Brachman Jr., PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

71004975 Issued in NU

Practice address

15900 S Cicero
Oak Forest, IL 60452

Phone

(708) 633-3478

Fax

(708) 633-3449

NPI assigned

Nov 29, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609943554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15900 S CICERO",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "60452",
            "telephone_number": "708-633-3478",
            "fax_number": "708-633-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15900 S CICERO",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "60452",
            "telephone_number": "708-633-3478",
            "fax_number": "708-633-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACHMAN",
        "first_name": "MALCOLM",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": "71004975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71004975",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Blanton, DC
• Charles Warren Bloom, BS,MS,CTRS
• Jennifer Alice Boender, LPC
• Brumentha Bony
• Isabella Monika Borzecki
• Bradley Therapy and Wellness
• Barry A Brandes, D.P.M.
• Sarah Jean Brandt
• Bremen Youth Services
• Gina Breuer, L.S.W.

• Psychologist in Oak Forest, IL
• Providers in Oak Forest, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.