Laurie Gwen Broutman, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Practice address

3333 Green Bay Rd
North Chicago, IL 60064-3037

Phone

(847) 578-8530

Fax

(847) 578-1019

NPI assigned

Jan 25, 2007

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Rosalind Franklin University of Medicine and Science

  • Clinical Medical Laboratory
  • North Chicago, IL
  • NPI 1073622254
  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699821710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 DEVONSHIRE CT",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353712",
            "telephone_number": "847-831-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 GREEN BAY RD",
            "city": "NORTH CHICAGO",
            "state": "IL",
            "postal_code": "600643037",
            "telephone_number": "847-578-8530",
            "fax_number": "847-578-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUTMAN",
        "first_name": "LAURIE",
        "middle_name": "GWEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrianna Brewton
• Ajla Brka
• Lejla Brka
• Karen Brodlo, BSN RN
• Cassidy Brooks
• Aubrye Christina Brower, PSYD
• Dylan Brown
• Shakira Ife Brown, PHARMD
• Tammy Lynn Brown, APN
• Scott C Brun, MD

• Internal Medicine Physician in North Chicago, IL
• Providers in North Chicago, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.