Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 036078342 | IL |
Y | 208200000X | Surgeon | 036078342 | IL |
Y | 208600000X | Surgeon | 036078342 | IL |
N | 2086S0102X | Surgical Critical Care | 036078342 | IL |
NPI | 1437139094 |
---|---|
Provider Name | Dr. John J Brems |
First Address | Elgin, IL 60123-2306 |
Second Address | Elgin, IL 60123-2306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 15/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4532923 | BCBS OF IL (01) | IL |
A12497 | (02) |