Kenneth Leon Bray, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036085284 Issued in IL

Practice address

1 Erie CT Ste 6040
Oak Park, IL 60302-2510

Phone

(708) 386-1301

Fax

(708) 386-3053

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Oak Park, IL
  • NPI 1871516799
  Medicare reassignment NPD
• PCC Community Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1134954506
  NPD
• Chicago Metropolitan Obstetricians & Gynecologists, LTD

  • Obstetrics & Gynecology Physician
  • Harvey, IL
  • NPI 1306913454
  NPD (past)
• Chicago Metropolitan Obstetricians Gynecologists and Pediatricians

  • Obstetrics & Gynecology Physician
  • Harvey, IL
  • NPI 1609216084
  NPD (past)
• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Orchid Suite Medical Group

  • Obstetrics & Gynecology Physician
  • Chicago, IL
  • NPI 1063555456
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1740295161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ERIE CT STE 6040",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022510",
            "telephone_number": "708-386-1301",
            "fax_number": "708-386-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ERIE CT STE 6040",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603022510",
            "telephone_number": "708-386-1301",
            "fax_number": "708-386-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "KENNETH",
        "middle_name": "LEON",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036085284",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085284",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Brandon Jr.
• Eileen Marie Brann, M.S., CCC-SLP
• Florence R Braum, L.C.S.W
• Bravo Pediatric Therapies
• Lorena Alexsandra Bravo-Molina, LSW
• Meghan A Breen, MSW
• Karina Breezer
• Sheila Maureen Brennan-Johnson
• Sherri Ann Brennan, R.D.
• Brian a. King

• Obstetrics & Gynecology Physician in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.