NPIMap

Individual provider Active NPI

Brent M Nathan, MD

  • Internal Medicine Physician
  • Bannockburn, IL
National Provider Identifier
1639559719
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036144667 Issued in IL
Practice address
2101 Waukegan Rd Ste 104
Bannockburn, IL 60015-1836
Phone
(847) 317-1717
Fax
(847) 317-9305
NPI assigned
Jun 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125067282 IL
Internal Medicine Physician 207R00000X 036144667 IL Primary

Addresses

Primary practice location

2101 Waukegan Rd Ste 104
Bannockburn, IL 60015-1836

Mailing address

2101 Waukegan Rd Ste 104
Bannockburn, IL 60015-1836
Phone (847) 317-1717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180808000020 IL Practitioner - Internal Medicine 1557651668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rush Medical College of Rush University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brent M Nathan MD PLLCGroup PAC ID 2365942885, 5 clinicians

Practice addresses (Care Compare)

2101 Waukegan Rd
Suite 200
Bannockburn, IL 60015-1800
Phone (847) 317-1717

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125067282ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brent M Nathan MD PLLC Internal Medicine CurrentSince Jul 23, 2025 Accepting new patients
David R. Buyer, MD, SC Internal Medicine CurrentSince Jul 16, 2018 Accepting new patients

Locations

2101 Waukegan Rd
Ste 104
Bannockburn, IL 60015
Phone (847) 317-1717

2101 Waukegan Rd
Ste 200
Bannockburn, IL 60015
Phone (847) 317-1717

850 S Wabash Ave
Ste 210
Chicago, IL 60605
Phone (219) 682-4944

1653 W Congress Pkwy
Chicago, IL 60612
Phone (312) 942-3138

1611 W Harrison St
Ste 212
Chicago, IL 60612
Phone (312) 942-4040

Interoperability endpoints

  • Direct secure messaging: brentnathan@drbmdsc.allscriptsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1639559719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 WAUKEGAN RD STE 104",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151836",
            "telephone_number": "847-317-1717",
            "fax_number": "847-317-9305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 WAUKEGAN RD STE 104",
            "city": "BANNOCKBURN",
            "state": "IL",
            "postal_code": "600151836",
            "telephone_number": "847-317-1717",
            "fax_number": "847-317-9305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "BRENT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-04",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125067282",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036144667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bannockburn, IL

Sources for this page

Verify at the official NPI Registry.