Individual provider Active NPI

Brittney Nowicki, DO

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1669975454
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036.157570 Issued in IL
Practice address
2734 W 87TH St
Chicago, IL 60652-3937
Phone
(773) 918-4700
Fax
(773) 313-3763
NPI assigned
Mar 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036.157570 IL Primary

Addresses

Primary practice location

2734 W 87TH St
Chicago, IL 60652-3937

Mailing address

2734 W 87TH St
Chicago, IL 60652-3937
Phone (773) 918-4700

Other practice location 1

660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

Other practice location 2

660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211103002939 IL Practitioner - Family Practice 3577807031 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Illinois Holding, LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

2734 W 87th St
Chicago, IL 60652
Phone (773) 918-4700

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1521244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1669975454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2734 W 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606523937",
            "telephone_number": "773-918-4700",
            "fax_number": "773-313-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2734 W 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606523937",
            "telephone_number": "773-918-4700",
            "fax_number": "773-313-3763"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 N Westmoreland Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "IL",
            "postal_code": "600451659",
            "country_code": "US",
            "telephone_number": "847-234-5600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "660 N Westmoreland Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "IL",
            "postal_code": "600451659",
            "country_code": "US",
            "telephone_number": "847-234-5600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOWICKI",
        "first_name": "BRITTNEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-17",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036.157570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.