Carol Irene Branka, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

355 Ridge Ave
Saint Rancis Hospital Physician Asssistance
Evanston, IL 60202-3328

Phone

(847) 316-6370

NPI assigned

Dec 27, 2007

Sex

Female

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1750565677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 N WABASH AVE",
            "address_2": "# 2607",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113591",
            "telephone_number": "312-836-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 RIDGE AVE",
            "address_2": "SAINT RANCIS HOSPITAL PHYSICIAN ASSSISTANCE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602023328",
            "telephone_number": "847-316-6370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANKA",
        "first_name": "CAROL",
        "middle_name": "IRENE",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Bozeday, LCSW
• Brianna K Brackin, DPT
• Carrie Grace Bradean, LCSW
• Curtis Bradford, M.D.
• Michelle Nadine Brand, MA, CCC, SLP
• Robert Brannick, PA-C
• Nicholas S Branock, LCSW
• Jyoti Eknoor Brar, M.B.B.S.
• Ankica Braun, MD
• David Braun, LCSW

• Medical Physician Assistant in Evanston, IL
• Providers in Evanston, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.