Individual provider Active NPI

Brigette Chelchowski, PA-C

  • Physician Assistant
  • Berwyn, IL
National Provider Identifier
1740808633
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085007554 Issued in IL
Practice address
6447 Cermak Rd
Berwyn, IL 60402-2311
Phone
(773) 254-1400
NPI assigned
Jul 8, 2020
Last updated
Jul 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085007554 IL Primary

Addresses

Primary practice location

6447 Cermak Rd
Berwyn, IL 60402-2311

Mailing address

6447 Cermak Rd
Berwyn, IL 60402-2311
Phone (773) 254-1300

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200722000820 IL Practitioner - Physician Assistant 8921422080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alivio Medical Center, Inc.Group PAC ID 5698840924, 23 clinicians

Practice addresses (Care Compare)

2355 S Western Ave
Chicago, IL 60608-3837
Phone (773) 254-1400

6447 Cermak Rd
Berwyn, IL 60402-2311
Phone (773) 254-1400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alivio Medical Center, Inc. CurrentSince Jul 13, 2020 Accepting new patients
Alivio Medical Center Inc CurrentSince Jul 13, 2020 Accepting new patients
Alivio Medical Center, Inc. Past Accepting new patients

Locations

6447 Cermak Rd
Berwyn, IL 60402
Phone (773) 254-1400

2355 S Western Ave
Chicago, IL 60608
Phone (773) 254-1400

966 W 21st St
Chicago, IL 60608
Phone (773) 254-1400

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1740808633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6447 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022311",
            "telephone_number": "773-254-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6447 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022311",
            "telephone_number": "773-254-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHELCHOWSKI",
        "first_name": "BRIGETTE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085007554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.