Scott C Brun, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036095736 Issued in IL

Practice address

1 N Waukegan Rd
Dept R435, BLDG Ap30-3
North Chicago, IL 60064-1802

Phone

(847) 935-1293

Fax

(847) 938-3711

NPI assigned

Jul 1, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1679956205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31048 PRAIRIE RIDGE RD",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600484898",
            "telephone_number": "847-935-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N WAUKEGAN RD",
            "address_2": "DEPT R435, BLDG AP30-3",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600641802",
            "telephone_number": "847-935-1293",
            "fax_number": "847-938-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUN",
        "first_name": "SCOTT",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036095736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurie Gwen Broutman, MD
• Aubrye Christina Brower, PSYD
• Dylan Brown
• Shakira Ife Brown, PHARMD
• Tammy Lynn Brown, APN
• Braden Brundage
• Heather Rae Bucher, LCSW
• Ryan Buechele, DMD
• Olga Bulakh, PHARMD
• Marie Bulfer

• Ophthalmology Physician in North Chicago, IL
• Providers in North Chicago, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.