Individual provider Active NPI

Khin Khin Bremer, MD

  • Pediatrics Physician
  • Downers Grove, IL
National Provider Identifier
1891157632
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036.148118 Issued in IL
Practice address
3825 Highland Avenue
Tower 1, Suite# 5H-5M
Downers Grove, IL 60515
Phone
(630) 275-9060
Fax
(630) 275-9065
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036.148118 IL Primary

Addresses

Primary practice location

3825 Highland Avenue
Tower 1, Suite# 5H-5M
Downers Grove, IL 60515

Mailing address

3825 Highland Avenue
Tower 1, Suite #5H-5M
Downers Grove, IL 60515
Phone (630) 275-9060

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kbremer208788@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190801001191 IL Practitioner - Pediatric Medicine 8426341165 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.148118ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Aug 16, 2019 Accepting new patients
Access Community Health Network CurrentSince Jan 13, 2020 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Aug 16, 2019 Accepting new patients
Access Community Health Network CurrentSince Jan 13, 2020 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Access Community Health Network Current Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

1 N Broadway St
Des Plaines, IL 60016
Phone (847) 298-3150

3825 Highland Ave
Ste 5H
Downers Grove, IL 60515
Phone (630) 275-9060

1675 W Dempster St
Park Ridge, IL 60068
Phone (847) 318-9300

Interoperability endpoints

  • Direct secure messaging: kbremer208788@direct.myadvocateaurora.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1891157632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 HIGHLAND AVENUE",
            "address_2": "TOWER 1, SUITE #5H-5M",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "60515",
            "telephone_number": "630-275-9060",
            "fax_number": "630-275-9065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 HIGHLAND AVENUE",
            "address_2": "TOWER 1, SUITE# 5H-5M",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "60515",
            "telephone_number": "630-275-9060",
            "fax_number": "630-275-9065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREMER",
        "first_name": "KHIN KHIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.148118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbremer208788@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3825 Highland Avenue",
            "address_2": "Tower 1, Suite# 5H-5M",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3825 Highland Avenue",
            "address_2": "Tower 1, Suite# 5H-5M",
            "city": "Downers Grove",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.