Active NPI
Nicholas Bravo, PHARMD
- Pharmacist
- Brookfield, IL
National Provider Identifier
1659976066
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051301477
- Practice address
- 8911 Ogden Ave
Brookfield, IL 60513-2005 - Phone
- (708) 485-5130
- NPI assigned
- Dec 2, 2020
- Last updated
- Dec 2, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051301477 | IL | Primary |
Addresses
Primary practice location
8911 Ogden Ave
Brookfield, IL 60513-2005
Mailing address
1242 W Huron St Apt 3
Chicago, IL 60642-0036
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051301477 | IL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1659976066",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1242 W HURON ST APT 3",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606420036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8911 OGDEN AVE",
"city": "BROOKFIELD",
"state": "IL",
"postal_code": "605132005",
"telephone_number": "708-485-5130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAVO",
"first_name": "NICHOLAS",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-02",
"last_updated": "2020-12-02",
"certification_date": "2020-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051301477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, IL
- Michael Berscheid, RPH
- Robert Blackwell
- Susan Blecha, LCSW
- Brianne Bolin, M.S. CCC-SLP/L
- Catherine Marie Bradley
- British Home for Retired Men and Women (The British Home)
- Brookfield Dental Studio PC
- Brookfield Oral Surgery, LLC (Brookfield Oral Surgery)
- Brookfield Smiles Inc.
- Adrian Marcus Cardenas, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.