Christopher Brenner, MD
Individual provider Active NPI Family Medicine Physician · Countryside, IL
NPI 1629020102 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1629020102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036073572 (IL)
- Practice address
- 9910 W 55TH St
Countryside, IL 60525-3612 - Phone
- (708) 352-6166
- Fax
- (708) 352-3864
- NPI assigned
- May 16, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 11
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Colorado School of Medicine, Denver, 1985
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Nani Internal Med LLC
Practice addresses (Care Compare)
412 63Rd St
Suite 100
Downers Grove, IL 60516-2000
Phone (331) 775-2783
Hospital & facility affiliations
- Uchicago Medicine Adventhealth Home Care
- Loyola Medicine Home Care
- Uchicago Medicine Adventhealth la Grange
- Uchicago Medicine Adventhealth Hinsdale
- Loyola University Medical Center
- Uchicago Medicine Adventhealth Bolingbrook
- Silver Cross Hospital and Medical Centers
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040506001247 | IL | Practitioner - Family Practice | 7810986874 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nani Internal Med LLC | Family Medicine | Current |
Accepting new patients |
| Adventist Midwest Health | Current | Accepting new patients | |
| Adventist Midwest Health | Family Medicine | Current |
Accepting new patients |
| Nani Internal Med Aco, LLC | Current |
Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients | |
| Nephrology Associates of Northern Illinois, LTD. | Past | Accepting new patients |
Locations
6438 Joliet Rd
Ste 203
Countryside, IL 60525
Phone (708) 352-5222
6438 Joliet Rd
Countryside, IL 60525
Phone (708) 352-5222
412 63rd St
Ste 100
Downers Grove, IL 60516
Phone (331) 775-2783
5201 Willow Springs Rd
La Grange Highlands, IL 60525
Phone (630) 323-5214
5101 Willow Springs Rd
Lagrange Hlds, IL 60525
Phone (708) 245-4073
120 W 22nd St
Oak Brook, IL 60523
2434 Wolf Rd
Westchester, IL 60154
Phone (630) 856-6800
Interoperability endpoints
- https://api.platform.athenahealth.com/18778/brand/1/csg/1/fhir/r4
- christopher.brenner.1@18778.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036073572 | IL | Yes |
Addresses
Primary practice location
9910 W 55TH St
Countryside, IL 60525-3612
Mailing address
9910 W 55TH St
Countryside, IL 60525-3612
Phone (708) 352-6166
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036073572 | Medicaid | IL |
Other providers in Countryside, IL
- Katherine A Biziorek
- Jamarice Blevins
- Blue Sky Van Rides LLC
- Josephine L Boggs
- Jocelyn Bonilla
- Catherine M Bruton
- Thomas Robert Bryson
- Steve Buda
- Eugene J Buksa
- Stacey L Carpenter
All providers in Countryside, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.