Individual provider Active NPI

Brett M Taylor, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1881063428
Registry record updated Sep 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085005634 Issued in IL
Practice address
675 N Saint Clair St Ste 19-100
Chicago, IL 60611-5969
Phone
(312) 664-3278
Fax
(312) 695-2461
NPI assigned
Sep 24, 2015
Last updated
Sep 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2022

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 085005634 IL Primary

Addresses

Primary practice location

675 N Saint Clair St Ste 19-100
Chicago, IL 60611-5969

Mailing address

675 N Saint Clair St Ste 19-100
Chicago, IL 60611-5969
Phone (312) 664-3278

Other practice location 1

201 E Huron St Ste 11-140
Chicago, IL 60611-2968
Phone (312) 695-2517

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, FL, WI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20151103002867 IL Practitioner - Physician Assistant 0648580662 Reassigns benefits to 8 organizations
I20191021003053 FL Practitioner - Physician Assistant 0648580662
I20191125002906 WI Practitioner - Physician Assistant 0648580662 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle West Physician Group IncGroup PAC ID 8921420308, 282 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

12251 S 80TH Ave
Palos Heights, IL 60463-1290

2204 Eastland Dr
Bloomington, IL 61704-3567
Phone (309) 663-0222

611 W Park St
Urbana, IL 61801-2500

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Health Physicians CurrentSince Jul 12, 2021 Accepting new patients
Carle Health Medical Group CurrentSince Oct 6, 2015 Accepting new patients
Methodist Medical Center of Illinois CurrentSince May 1, 2024 Accepting new patients
Methodist Medical Center of Illinois CurrentSince May 1, 2024 Accepting new patients
Riverside Health System CurrentSince Jan 28, 2021 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 1, 2022 Accepting new patients
Carle West Physician Group Inc CurrentSince Jan 27, 2021 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Physician Assistant CurrentSince Nov 26, 2019 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Oct 24, 2019 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Oct 24, 2019 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

Dept 5777
Carol Stream, IL 60122

201 E Huron St
Ste 11-140
Chicago, IL 60611
Phone (312) 664-3278

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

675 N Saint Clair St
Ste 19100
Chicago, IL 60611
Phone (312) 664-3278

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

1302 Franklin Ave
Ste 4500
Normal, IL 61761
Phone (309) 556-8300

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 671-7779

120 NE Glen Oak Ave
Peoria, IL 61603
Phone (309) 672-3158

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

900 Main St
Ste 660
Peoria, IL 61602
Phone (309) 272-7724

2300 N Rockton Ave
Rockford, IL 61103

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1881063428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 19-100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115969",
            "telephone_number": "312-664-3278",
            "fax_number": "312-695-2461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 N SAINT CLAIR ST STE 19-100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115969",
            "telephone_number": "312-664-3278",
            "fax_number": "312-695-2461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 E Huron St Ste 11-140",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112968",
            "country_code": "US",
            "telephone_number": "312-695-2517",
            "fax_number": "312-695-5774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "BRETT",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-24",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.